WorldWideScience

Sample records for evaluating systematic dependencies

  1. EVALUATING SYSTEMATIC DEPENDENCIES OF TYPE Ia SUPERNOVAE: THE INFLUENCE OF PROGENITOR 22Ne CONTENT ON DYNAMICS

    International Nuclear Information System (INIS)

    Townsley, Dean M.; Jackson, Aaron P.; Calder, Alan C.; Chamulak, David A.; Brown, Edward F.; Timmes, F. X.

    2009-01-01

    We present a theoretical framework for formal study of systematic effects in supernovae Type Ia (SNe Ia) that utilizes two-dimensional simulations to implement a form of the deflagration-detonation transition (DDT) explosion scenario. The framework is developed from a randomized initial condition that leads to a sample of simulated SNe Ia whose 56 Ni masses have a similar average and range to those observed, and have many other modestly realistic features such as the velocity extent of intermediate-mass elements. The intended purpose is to enable statistically well defined studies of both physical and theoretical parameters of the SNe Ia explosion simulation. We present here a thorough description of the outcome of the SNe Ia explosions produced by our current simulations. A first application of this framework is utilized to study the dependence of the SNe Ia on the 22 Ne content, which is known to be directly influenced by the progenitor stellar population's metallicity. Our study is very specifically tailored to measure how the 22 Ne content influences the competition between the rise of plumes of burned material and the expansion of the star before these plumes reach DDT conditions. This influence arises from the dependence of the energy release, progenitor structure, and laminar flame speed on 22 Ne content. For this study, we explore these three effects for a fixed carbon content and DDT density. By setting the density at which nucleosynthesis takes place during the detonation phase of the explosion, the competition between plume rise and stellar expansion controls the amount of material in nuclear statistical equilibrium (NSE) and therefore 56 Ni produced. Of particular interest is how this influence of 22 Ne content compares to the direct modification of the 56 Ni mass via the inherent neutron excess as discussed by Timmes et al. Although the outcome following from any particular ignition condition can change dramatically with 22 Ne content, with a sample of

  2. Emotional dependency: a systematic review of literature

    OpenAIRE

    Denise Catricala Bution; Amanda Muglia Wechsler

    2016-01-01

    Emotional Dependency is a disorder characterized by addictive behaviors in romantic relationships. However, there is still controversy about whether this dependency should be considered pathological, as well as its appropriate denomination and the symptoms that would define it. This paper presents a systematic evaluation of the literature on emotional dependency, reviewing all the indexed articles in Scielo, CAPES, and Scholar Google databases, published between 2000 and 2014. After careful a...

  3. Systematic, Cooperative Evaluation.

    Science.gov (United States)

    Nassif, Paula M.

    Evaluation procedures based on a systematic evaluation methodology, decision-maker validity, new measurement and design techniques, low cost, and a high level of cooperation on the part of the school staff were used in the assessment of a public school mathematics program for grades 3-8. The mathematics curriculum was organized into Spirals which…

  4. Pain and Opioid Addiction: A Systematic Review and Evaluation of Pain Measurement in Patients with Opioid Dependence on Methadone Maintenance Treatment.

    Science.gov (United States)

    Dennis, B B; Bawor, M; Paul, J; Plater, C; Pare, G; Worster, A; Varenbut, M; Daiter, J; Marsh, D C; Desai, D; Thabane, L; Samaan, Z

    2016-01-01

    While chronic pain has been said to impact patient's response to methadone maintenance treatment for opioid dependence, the reported findings are inconsistent. These discrepancies may be a direct result of variations in the measurement of chronic pain or definitions of response to methadone treatment. The goal of this study is to evaluate the association between pain and substance use behaviour to determine the real impact of comorbid pain in the methadone population. We also aim to examine sources of variation across the literature with a specific focus on the measurement of pain. We performed a systematic review using an electronic search strategy across CINAHL, MEDLINE, Web of Science, PsychINFO, EMBASE, and the Cochrane Library including Cochrane Reviews and the Cochrane Central Register of Controlled Trials databases. Title, abstract, as well as full text screening and extraction were performed in duplicate. Studies evaluating the association between chronic pain and methadone maintenance treatment response were eligible for inclusion in this review. Using a sample of 297 methadone patients from the Genetics of Opioid Addiction (GENOA) research collaborative, we assessed the reliability of patient self-reported pain and the validated Brief Pain Inventory (BPI) assessment tool. After screening 826 articles we identified five studies eligible for full text extraction, of which three showed a significant relationship between the presence of pain and the increase in substance abuse among patients on methadone for the treatment of opioid dependence. Studies varied largely in the definitions and measurement of both pain and response to treatment. Results from our validation of pain measurement in the GENOA sample (n=297) showed the use of a simple self-reported pain question is highly correlated to the use of the BPI. Simply asking patients whether they have pain showed a 44.2% sensitivity, 88.8% specificity, 84.4% PPV and 53.6% NPV to the BPI. The area under the

  5. A practice-driven systematic review of dependency analysis solutions

    NARCIS (Netherlands)

    Callo Arias, Trosky B.; Spek, Pieter van der; Avgeriou, Paris

    2011-01-01

    When following architecture-driven strategies to develop large software-intensive systems, the analysis of the dependencies is not an easy task. In this paper, we report a systematic literature review on dependency analysis solutions. Dependency analysis concerns making dependencies due to

  6. Evaluating clinical librarian services: a systematic review.

    Science.gov (United States)

    Brettle, Alison; Maden-Jenkins, Michelle; Anderson, Lucy; McNally, Rosalind; Pratchett, Tracey; Tancock, Jenny; Thornton, Debra; Webb, Anne

    2011-03-01

      Previous systematic reviews have indicated limited evidence and poor quality evaluations of clinical librarian (CL) services. Rigorous evaluations should demonstrate the value of CL services, but guidance is needed before this can be achieved.   To undertake a systematic review which examines models of CL services, quality, methods and perspectives of clinical librarian service evaluations.   Systematic review methodology and synthesis of evidence, undertaken collaboratively by a group of 8 librarians to develop research and critical appraisal skills.   There are four clear models of clinical library service provision. Clinical librarians are effective in saving health professionals time, providing relevant, useful information and high quality services. Clinical librarians have a positive effect on clinical decision making by contributing to better informed decisions, diagnosis and choice of drug or therapy. The quality of CL studies is improving, but more work is needed on reducing bias and providing evidence of specific impacts on patient care. The Critical Incident Technique as part of a mixed method approach appears to offer a useful approach to demonstrating impact.   This systematic review provides practical guidance regarding the evaluation of CL services. It also provides updated evidence regarding the effectiveness and impact of CL services. The approach used was successful in developing research and critical appraisal skills in a group of librarians. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

  7. Systematic evaluation program, status summary report

    International Nuclear Information System (INIS)

    1983-01-01

    Status reports are presented on the systematic evaluation program for the Big Rock Point reactor, Dresden-1 reactor, Dresden-2 reactor, Ginna-1 reactor, Connecticut Yankee reactor, LACBWR reactor, Millstone-1 reactor, Oyster Creek-1 reactor, Palisades-1 reactor, San Onofre-1 reactor, and Rowe Yankee reactor

  8. Evaluating Dependence Criteria for Caffeine.

    Science.gov (United States)

    Striley, Catherine L W; Griffiths, Roland R; Cottler, Linda B

    2011-12-01

    Background: Although caffeine is the most widely used mood-altering drug in the world, few studies have operationalized and characterized Diagnostic and Statistical Manual IV (DSM-IV) substance dependence criteria applied to caffeine. Methods: As a part of a nosological study of substance use disorders funded by the National Institute on Drug Abuse, we assessed caffeine use and dependence symptoms among high school and college students, drug treatment patients, and pain clinic patients who reported caffeine use in the last 7 days and also reported use of alcohol, nicotine, or illicit drugs within the past year ( n =167). Results: Thirty-five percent met the criteria for dependence when all seven of the adopted DSM dependence criteria were used. Rates of endorsement of several of the most applicable diagnostic criteria were as follows: 26% withdrawal, 23% desire to cut down or control use, and 44% continued use despite harm. In addition, 34% endorsed craving, 26% said they needed caffeine to function, and 10% indicated that they talked to a physician or counselor about problems experienced with caffeine. There was a trend towards increased caffeine dependence among those dependent on nicotine or alcohol. Within a subgroup that had used caffeine, alcohol, and nicotine in the past year, 28% fulfilled criteria for caffeine dependence compared to 50% for alcohol and 80% for nicotine. Conclusion: The present study adds to a growing literature suggesting the reliability, validity, and clinical utility of the caffeine dependence diagnosis. Recognition of caffeine dependence in the DSM-V may be clinically useful.

  9. Evaluating Dependence Criteria for Caffeine

    OpenAIRE

    Striley, Catherine L.W.; Griffiths, Roland R.; Cottler, Linda B.

    2011-01-01

    Background: Although caffeine is the most widely used mood-altering drug in the world, few studies have operationalized and characterized Diagnostic and Statistical Manual IV (DSM-IV) substance dependence criteria applied to caffeine. Methods: As a part of a nosological study of substance use disorders funded by the National Institute on Drug Abuse, we assessed caffeine use and dependence symptoms among high school and college students, drug treatment patients, and pain clinic patients who re...

  10. Conducting systematic reviews of economic evaluations.

    Science.gov (United States)

    Gomersall, Judith Streak; Jadotte, Yuri Tertilus; Xue, Yifan; Lockwood, Suzi; Riddle, Dru; Preda, Alin

    2015-09-01

    In 2012, a working group was established to review and enhance the Joanna Briggs Institute (JBI) guidance for conducting systematic review of evidence from economic evaluations addressing a question(s) about health intervention cost-effectiveness. The objective is to present the outcomes of the working group. The group conducted three activities to inform the new guidance: review of literature on the utility/futility of systematic reviews of economic evaluations and consideration of its implications for updating the existing methodology; assessment of the critical appraisal tool in the existing guidance against criteria that promotes validity in economic evaluation research and two other commonly used tools; and a workshop. The debate in the literature on the limitations/value of systematic review of economic evidence cautions that systematic reviews of economic evaluation evidence are unlikely to generate one size fits all answers to questions about the cost-effectiveness of interventions and their comparators. Informed by this finding, the working group adjusted the framing of the objectives definition in the existing JBI methodology. The shift is away from defining the objective as to determine one cost-effectiveness measure toward summarizing study estimates of cost-effectiveness and informed by consideration of the included study characteristics (patient, setting, intervention component, etc.), identifying conditions conducive to lowering costs and maximizing health benefits. The existing critical appraisal tool was included in the new guidance. The new guidance includes the recommendation that a tool designed specifically for the purpose of appraising model-based studies be used together with the generic appraisal tool for economic evaluations assessment to evaluate model-based evaluations. The guidance produced by the group offers reviewers guidance for each step of the systematic review process, which are the same steps followed in JBI reviews of other

  11. Dependability Evaluation of Advanced Diverse Protection System

    International Nuclear Information System (INIS)

    Oh, Yang Gyun; Lee, Yoon Hee; Sohn, Se Do; Baek, Seung Min; Lee, Sang Jeong

    2014-01-01

    For the mitigation of anticipated transients without scram (ATWS) as well as common cause failure (CCF) within the plant protection system (PPS) and the emergency safety feature . component control system (ESF-CCS), the diverse protection system (DPS) has been designed by KEPCO Engineering and Construction Company. Recently KEPCO E and C has developed the advanced diverse protection system (ADPS), which has four redundant channels, in an attempt to enhance a fault-tolerant capability of the system. For the evaluation of overall system improvement effects of the ADPS compared with the DPS, the dependability evaluation results are described herein. For all dependability attributes, this paper suggests a practical dependability evaluation method which uses quantitative dependability scores and indices. An overall dependability evaluation index (DEI) for the ADPS is evaluated with the average value of reliability/ security/maintainability/safety indices (i.e., RID, SID, MID, and SID') for dependability. The evaluation results show that the DEI value of ADPS can be improved by approximately 23% compared with that of the DPS, thanks to its fault-tolerant system architecture, software design changes, and external interface design features. Several suggestions have been made, in this paper, of an overall quantitative dependability evaluation method for the nuclear instrumentation and control (I and C) systems including the DPS and ADPS, and the usefulness of dependability evaluation on nuclear I and C systems has been confirmed

  12. NRC systematic evaluation program: seismic review

    International Nuclear Information System (INIS)

    Levin, H.A.

    1980-01-01

    The NRC Systematic Evaluation Program is currently making an assessment of the seismic design safety of 11 older nuclear power plant facilities. The general review philosophy and review criteria relative to seismic input, structural response, and equipment functionability are presented, including the rationale for the development of these guidelines considering the significant evolution of seismic design criteria since these plants were originally licensed. Technical approaches thought more realistic in light of current knowledge are utilized. Initial findings for plants designed to early seismic design procedures suggest that with minor exceptions, these plants possess adequate seismic design margins when evaluated against the intent of current criteria. However, seismic qualification of electrical equipment has been identified as a subject which requires more in-depth evaluation

  13. Evaluation of Data with Systematic Errors

    International Nuclear Information System (INIS)

    Froehner, F. H.

    2003-01-01

    Application-oriented evaluated nuclear data libraries such as ENDF and JEFF contain not only recommended values but also uncertainty information in the form of 'covariance' or 'error files'. These can neither be constructed nor utilized properly without a thorough understanding of uncertainties and correlations. It is shown how incomplete information about errors is described by multivariate probability distributions or, more summarily, by covariance matrices, and how correlations are caused by incompletely known common errors. Parameter estimation for the practically most important case of the Gaussian distribution with common errors is developed in close analogy to the more familiar case without. The formalism shows that, contrary to widespread belief, common ('systematic') and uncorrelated ('random' or 'statistical') errors are to be added in quadrature. It also shows explicitly that repetition of a measurement reduces mainly the statistical uncertainties but not the systematic ones. While statistical uncertainties are readily estimated from the scatter of repeatedly measured data, systematic uncertainties can only be inferred from prior information about common errors and their propagation. The optimal way to handle error-affected auxiliary quantities ('nuisance parameters') in data fitting and parameter estimation is to adjust them on the same footing as the parameters of interest and to integrate (marginalize) them out of the joint posterior distribution afterward

  14. Parameters Evaluation of PLC Dependability and Safety

    Directory of Open Access Journals (Sweden)

    Juraj Zdansky

    2006-01-01

    Full Text Available This paper is focused on evaluation of dependability and safety parameters of PLC (Programmable Logic Controller. Achievement of requested level of these parameters is an application assumption for using PLC in control of safety critical processes. Evaluation of these parameters can be made on the base of suitable model and it can be influenced by system architecture when necessary.

  15. Evaluation of temperature dependent neutron resonance integrals

    International Nuclear Information System (INIS)

    Menon, S.V.G.; Sahni, D.C.

    1975-01-01

    The Fourier transform method is extended for evaluating temperature dependent resonance integrals and Doppler coefficients. With the temperature dependent cross-sections, the slowing-down equation is transformed into a Fredholm integral equation of second kind. A method of solution is presented using the familiar Gauss-Hermite quadrature formulae. As a byproduct of the above technique, a fast and accurate method for computing the resonance integral J-function is given. (orig.) [de

  16. What does dependency on community mental health services mean? A conceptual review with a systematic search.

    Science.gov (United States)

    Bonavigo, Tommaso; Sandhu, Sima; Pascolo-Fabrici, Elisabetta; Priebe, Stefan

    2016-04-01

    Although community mental health services aim to support patients' autonomy and independence, they have repeatedly been criticised for making patients dependent. Yet, it remains often unclear what exactly is meant with dependency in this context. This review aimed to identify the meaning of the term dependency on community services in the literature. A systematic search and conceptual review of papers where dependency is used in the context of community mental health services. Narrative synthesis was used to identify thematic concepts linked to dependency in these settings. Fifteen papers met the inclusion criteria. The analysis identified five different concepts of dependency on community mental health services: dislocation from the outside world; inflexibility and lack of freedom; obligation as resentment or appreciation; living with or without meaningful activities; and security. The findings suggest that, distinct from the exclusively negative connotation of the term dependency in a conventional medical context, dependency on community mental health services contains both negative and positive aspects. The different aspects might guide the future evaluation of the care provided in such services.

  17. Evaluation Framework for Dependable Mobile Learning Scenarios

    Science.gov (United States)

    Bensassi, Manel; Laroussi, Mona

    2014-01-01

    The goal of the dependability analysis is to predict inconsistencies and to reveal ambiguities and incompleteness in the designed learning scenario. Evaluation, in traditional learning design, is generally planned after the execution of the scenario. In mobile learning, this stage becomes too difficult and expensive to apply due to the complexity…

  18. Systematic evaluation of skeletal mechanical function.

    Science.gov (United States)

    Smith, Lauren; Bigelow, Erin M R; Jepsen, Karl J

    2013-06-01

    Many genetic and environmental perturbations lead to measurable changes in bone morphology, matrix composition, and matrix organization. The skeletal system is highly adaptive, such that genetic and environmental perturbations affecting one trait are often accompanied by compensatory changes in other traits. This adaptation should be considered when attempting to draw meaningful conclusions about the role of a gene, for example. The challenge is to figure out which alterations can be attributed to the perturbation and which result from adaptive changes associated with establishing mechanical function. The goal of this chapter is to describe straight-forward biomechanical methods that can be used to determine whether a genetic or environmental perturbation affected bone strength. We introduce a systematic method for evaluating how bone strength was altered in the context of morphology and tissue-level mechanical properties, which are determined in large part from matrix composition, matrix organization, and porosity. We present this work as a first step toward screening mice for a phenotypic effect and for establishing the associated biomechanical mechanism by which function was altered. The outcome of these analyses generally provides insight into the next set of experiments required to further connect the cellular perturbation with the functional changes. The protocols were written to enable researchers without a background in engineering to conduct the assays or to enable researchers to better understand the outcomes of similar assays conducted by colleagues knowledgeable in engineering.

  19. Systematic evaluation program. Status report and initial evaluation

    International Nuclear Information System (INIS)

    1983-06-01

    The MHB Ongoing Systematic Evaluation Program (SEP) Assessment Study was initiated by the Swedish Nuclear Power Inspectorate (SKI) in 1980. This MHB report is a status report and initial evaluation of SEP. The methodology and results of SEP are disscused with particular emphasis on the first two SEP plant reviews - the Palisades and R.E. Ginna nuclear power plants. The comments of cognizant persons in the NRC and the ACRS, as well as private consultants, are included herein. MHBs major findings are as follows: The SEP plant review methodology was acceptable to the NRC Commissioners, the ACRS, and the NRC Staffs consultants who evaluated the first two SEP plant reviews. A concern raised by all who commented on SEP was the absence of Three Mile Island Action Plan Items and Unresolved Safety Issues from current SEP reviews. The SEP reviews of the Palisades and R.E. Ginna plants concluded that the two plant designs were adequate with respect to a majority of safety topics. Several topics remain unresolved in both the Palisades and R.E. Ginna SEP reviews. In the case of the Ginna plant, several related topics have been grouped together in a major structural reevaluation study. In general, due to the number of unresolved and excluded topics, SEP has not at this time produced a plant safety evaluation which can be considered complete and integrated. (author)

  20. Software Dependability and Safety Evaluations ESA's Initiative

    Science.gov (United States)

    Hernek, M.

    ESA has allocated funds for an initiative to evaluate Dependability and Safety methods of Software. The objectives of this initiative are; · More extensive validation of Safety and Dependability techniques for Software · Provide valuable results to improve the quality of the Software thus promoting the application of Dependability and Safety methods and techniques. ESA space systems are being developed according to defined PA requirement specifications. These requirements may be implemented through various design concepts, e.g. redundancy, diversity etc. varying from project to project. Analysis methods (FMECA. FTA, HA, etc) are frequently used during requirements analysis and design activities to assure the correct implementation of system PA requirements. The criticality level of failures, functions and systems is determined and by doing that the critical sub-systems are identified, on which dependability and safety techniques are to be applied during development. Proper performance of the software development requires the development of a technical specification for the products at the beginning of the life cycle. Such technical specification comprises both functional and non-functional requirements. These non-functional requirements address characteristics of the product such as quality, dependability, safety and maintainability. Software in space systems is more and more used in critical functions. Also the trend towards more frequent use of COTS and reusable components pose new difficulties in terms of assuring reliable and safe systems. Because of this, its dependability and safety must be carefully analysed. ESA identified and documented techniques, methods and procedures to ensure that software dependability and safety requirements are specified and taken into account during the design and development of a software system and to verify/validate that the implemented software systems comply with these requirements [R1].

  1. Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature.

    Science.gov (United States)

    Tofighi, Babak; Nicholson, Joseph M; McNeely, Jennifer; Muench, Frederick; Lee, Joshua D

    2017-07-01

    Mobile phone use has increased dramatically and concurrent with rapid developments in mobile phone-based health interventions. The integration of text messaging interventions promises to optimise the delivery of care for persons with substance dependence with minimal disruption to clinical workflows. We conducted a systematic review to assess the acceptability, feasibility and clinical impact of text messaging interventions for persons with illicit drug and alcohol dependence. Studies were required to evaluate the use of text messaging as an intervention for persons who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition criterion for a diagnosis of illicit drug and/or alcohol dependence. Authors searched for articles published to date in MEDLINE (pubmed.gov), the Cochrane Library, EMBASE, CINAHL, Google Scholar and PsychINFO. Eleven articles met the search criteria for this review and support the acceptability and feasibility of text messaging interventions for addressing illicit drug and alcohol dependence. Most studies demonstrated improved clinical outcomes, medication adherence and engagement with peer support groups. Text messaging interventions also intervened on multiple therapeutic targets such as appointment attendance, motivation, self-efficacy, relapse prevention and social support. Suggestions for future research are described, including intervention design features, clinician contact, privacy measures and integration of behaviour change theories. Text messaging interventions offer a feasible platform to address a range of substances (i.e. alcohol, methamphetamine, heroin and alcohol), and there is increasing evidence supporting further larger-scale studies. [Tofighi B, Nicholson JM, McNeely J, Muench F, Lee JD. Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature. Drug Alcohol Rev 2017;36:477-491]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  2. Empirical Evaluation of Directional-Dependence Tests

    Science.gov (United States)

    Thoemmes, Felix

    2015-01-01

    Testing of directional dependence is a method to infer causal direction that recently has attracted some attention. Previous examples by e.g. von Eye and DeShon (2012a) and extensive simulation studies by Pornprasertmanit and Little (2012) have demonstrated that under specific assumptions, directional-dependence tests can recover the true causal…

  3. SYSTEMATICITY OF L1 THAI LEARNERS' ENGLISH INTERLANGUAGE OF DEPENDENT PREPOSITIONS

    Directory of Open Access Journals (Sweden)

    Piyaboot Sumonsriworakun

    2017-01-01

    Full Text Available The study investigates systematicity in English interlanguage of dependent prepositions among L1 Thai learners of L2 English. It is hypothesized that Thai learners show non-random use of English dependent prepositions in their English interlanguage, and that the systematicity is largely attributable to cross-linguistic influence and certain cognitive factors. To test the hypothesis, 30 L1 Thai undergraduate students of L2 English at elementary, intermediate, and advanced proficiency levels took two tests: a Thai–English translation test and a cloze test. The tests involved four types of relationship between English and Thai dependent prepositions: (1 [–prep] in English but [+prep] in Thai, (2 [+prep] in English but [–prep] in Thai, (3 [+prep1] in English but [+prep2] in Thai, and (4 [+prep] in English and [+prep] in Thai. The findings demonstrate that systematicity occurred in the learners’ English usage of prepositions of all such types, possibly due to negative transfer from the learners’ native language. Also, the L2 learners tended to exhibit such systematicity irrespective of their English proficiency level. It may be assumed that the cognitive aspect of L2 learners’ working memory is involved in processing the usage of the four types of English dependent prepositions. The results of the study are expected to shed light on the problems of L2 English interlanguage of dependent prepositions among L1 Thai learners.

  4. ac driving amplitude dependent systematic error in scanning Kelvin probe microscope measurements: Detection and correction

    International Nuclear Information System (INIS)

    Wu Yan; Shannon, Mark A.

    2006-01-01

    The dependence of the contact potential difference (CPD) reading on the ac driving amplitude in scanning Kelvin probe microscope (SKPM) hinders researchers from quantifying true material properties. We show theoretically and demonstrate experimentally that an ac driving amplitude dependence in the SKPM measurement can come from a systematic error, and it is common for all tip sample systems as long as there is a nonzero tracking error in the feedback control loop of the instrument. We further propose a methodology to detect and to correct the ac driving amplitude dependent systematic error in SKPM measurements. The true contact potential difference can be found by applying a linear regression to the measured CPD versus one over ac driving amplitude data. Two scenarios are studied: (a) when the surface being scanned by SKPM is not semiconducting and there is an ac driving amplitude dependent systematic error; (b) when a semiconductor surface is probed and asymmetric band bending occurs when the systematic error is present. Experiments are conducted using a commercial SKPM and CPD measurement results of two systems: platinum-iridium/gap/gold and platinum-iridium/gap/thermal oxide/silicon are discussed

  5. Systematic safety evaluation of old nuclear power plants

    International Nuclear Information System (INIS)

    Dredemis, G.; Fourest, B.

    1984-01-01

    The French safety authorities have undertaken a systematic evaluation of the safety of old nuclear power plants. Apart from a complete revision of safety documents (safety analysis report, general operating rules, incident and accident procedures, internal emergency plan, quality organisation manual), this examination consisted of analysing the operating experience of systems frequently challenged and a systematic examination of the safety-related systems. This paper is based on an exercise at the Ardennes Nuclear Power Plant which has been in operation for 15 years. This paper also summarizes the main surveys and modifications relating to this power plant. (orig.)

  6. [Systematic economic assessment and quality evaluation for traditional Chinese medicines].

    Science.gov (United States)

    Sun, Xiao; Guo, Li-ping; Shang, Hong-cai; Ren, Ming; Lei, Xiang

    2015-05-01

    To learn about the economic studies on traditional Chinese medicines in domestic literatures, in order to analyze the current economic assessment of traditional Chinese medicines and explore the existing problems. Efforts were made to search CNKI, VIP, Wanfang database and CBM by computer and include all literatures about economic assessment of traditional Chinese medicines published on professional domestic journals in the systematic assessment and quality evaluation. Finally, 50 articles were included in the study, and the systematic assessment and quality evaluation were made for them in terms of titles, year, authors' identity, expense source, disease type, study perspective, study design type, study target, study target source, time limit, cost calculation, effect indicator, analytical technique and sensitivity analysis. The finally quality score was 0.74, which is very low. The results of the study showed insufficient studies on economics of traditional Chinese medicines, short study duration and simple evaluation methods, which will be solved through unremitting efforts in the future.

  7. Systematic studies of binding energy dependence of neutron-proton momentum correlation function

    International Nuclear Information System (INIS)

    Wei, Y B; Ma, Y G; Shen, W Q; Ma, G L; Wang, K; Cai, X Z; Zhong, C; Guo, W; Chen, J G; Fang, D Q; Tian, W D; Zhou, X F

    2004-01-01

    Hanbury Brown-Twiss (HBT) results of the neutron-proton correlation function have been systematically investigated for a series of nuclear reactions with light projectiles with the help of the isospin-dependent quantum molecular dynamics model. The relationship between the binding energy per nucleon of the projectiles and the strength of the neutron-proton HBT at small relative momentum has been obtained. Results show that neutron-proton HBT results are sensitive to the binding energy per nucleon

  8. Acknowledging patient heterogeneity in economic evaluation : a systematic literature review.

    Science.gov (United States)

    Grutters, Janneke P C; Sculpher, Mark; Briggs, Andrew H; Severens, Johan L; Candel, Math J; Stahl, James E; De Ruysscher, Dirk; Boer, Albert; Ramaekers, Bram L T; Joore, Manuela A

    2013-02-01

    Patient heterogeneity is the part of variability that can be explained by certain patient characteristics (e.g. age, disease stage). Population reimbursement decisions that acknowledge patient heterogeneity could potentially save money and increase population health. To date, however, economic evaluations pay only limited attention to patient heterogeneity. The objective of the present paper is to provide a comprehensive overview of the current knowledge regarding patient heterogeneity within economic evaluation of healthcare programmes. A systematic literature review was performed to identify methodological papers on the topic of patient heterogeneity in economic evaluation. Data were obtained using a keyword search of the PubMed database and manual searches. Handbooks were also included. Relevant data were extracted regarding potential sources of patient heterogeneity, in which of the input parameters of an economic evaluation these occur, methods to acknowledge patient heterogeneity and specific concerns associated with this acknowledgement. A total of 20 articles and five handbooks were included. The relevant sources of patient heterogeneity (demographics, preferences and clinical characteristics) and the input parameters where they occurred (baseline risk, treatment effect, health state utility and resource utilization) were combined in a framework. Methods were derived for the design, analysis and presentation phases of an economic evaluation. Concerns related mainly to the danger of false-positive results and equity issues. By systematically reviewing current knowledge regarding patient heterogeneity within economic evaluations of healthcare programmes, we provide guidance for future economic evaluations. Guidance is provided on which sources of patient heterogeneity to consider, how to acknowledge them in economic evaluation and potential concerns. The improved acknowledgement of patient heterogeneity in future economic evaluations may well improve the

  9. Pacemaker Dependency after Cardiac Surgery: A Systematic Review of Current Evidence.

    Science.gov (United States)

    Steyers, Curtis M; Khera, Rohan; Bhave, Prashant

    2015-01-01

    Severe postoperative conduction disturbances requiring permanent pacemaker implantation frequently occur following cardiac surgery. Little is known about the long-term pacing requirements and risk factors for pacemaker dependency in this population. We performed a systematic review of the literature addressing rates and predictors of pacemaker dependency in patients requiring permanent pacemaker implantation after cardiac surgery. Using a comprehensive search of the Medline, Web of Science and EMBASE databases, studies were selected for review based on predetermined inclusion and exclusion criteria. A total of 8 studies addressing the endpoint of pacemaker-dependency were identified, while 3 studies were found that addressed the recovery of atrioventricular (AV) conduction endpoint. There were 10 unique studies with a total of 780 patients. Mean follow-up ranged from 6-72 months. Pacemaker dependency rates ranged from 32%-91% and recovery of AV conduction ranged from 16%-42%. There was significant heterogeneity with respect to the definition of pacemaker dependency. Several patient and procedure-specific variables were found to be independently associated with pacemaker dependency, but these were not consistent between studies. Pacemaker dependency following cardiac surgery occurs with variable frequency. While individual studies have identified various perioperative risk factors for pacemaker dependency and non-resolution of AV conduction disease, results have been inconsistent. Well-conducted studies using a uniform definition of pacemaker dependency might identify patients who will benefit most from early permanent pacemaker implantation after cardiac surgery.

  10. Systematic evaluations of probabilistic floor response spectrum generation

    International Nuclear Information System (INIS)

    Lilhanand, K.; Wing, D.W.; Tseng, W.S.

    1985-01-01

    The relative merits of the current methods for direct generation of probabilistic floor response spectra (FRS) from the prescribed design response spectra (DRS) are evaluated. The explicit probabilistic methods, which explicitly use the relationship between the power spectral density function (PSDF) and response spectra (RS), i.e., the PSDF-RS relationship, are found to have advantages for practical applications over the implicit methods. To evaluate the accuracy of the explicit methods, the root-mean-square (rms) response and the peak factor contained in the PSDF-RS relationship are systematically evaluated, especially for the narrow-band floor spectral response, by comparing the analytical results with simulation results. Based on the evaluation results, a method is recommended for practical use for the direct generation of probabilistic FRS. (orig.)

  11. Economic evaluation of vaccines in Canada: A systematic review.

    Science.gov (United States)

    Chit, Ayman; Lee, Jason K H; Shim, Minsup; Nguyen, Van Hai; Grootendorst, Paul; Wu, Jianhong; Van Exan, Robert; Langley, Joanne M

    2016-05-03

    Economic evaluations should form part of the basis for public health decision making on new vaccine programs. While Canada's national immunization advisory committee does not systematically include economic evaluations in immunization decision making, there is increasing interest in adopting them. We therefore sought to examine the extent and quality of economic evaluations of vaccines in Canada. We conducted a systematic review of economic evaluations of vaccines in Canada to determine and summarize: comprehensiveness across jurisdictions, studied vaccines, funding sources, study designs, research quality, and changes over time. Searches in multiple databases were conducted using the terms "vaccine," "economics" and "Canada." Descriptive data from eligible manuscripts was abstracted and three authors independently evaluated manuscript quality using a 7-point Likert-type scale scoring tool based on criteria from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). 42/175 articles met the search criteria. Of these, Canada-wide studies were most common (25/42), while provincial studies largely focused on the three populous provinces of Ontario, Quebec and British Columbia. The most common funding source was industry (17/42), followed by government (7/42). 38 studies used mathematical models estimating expected economic benefit while 4 studies examined post-hoc data on established programs. Studies covered 10 diseases, with 28/42 addressing pediatric vaccines. Many studies considered cost-utility (22/42) and the majority of these studies reported favorable economic results (16/22). The mean quality score was 5.9/7 and was consistent over publication date, funding sources, and disease areas. We observed diverse approaches to evaluate vaccine economics in Canada. Given the increased complexity of economic studies evaluating vaccines and the impact of results on public health practice, Canada needs improved, transparent and consistent processes

  12. Systematic Review of Health Economic Impact Evaluations of Risk Prediction Models : Stop Developing, Start Evaluating

    NARCIS (Netherlands)

    van Giessen, Anoukh; Peters, Jaime; Wilcher, Britni; Hyde, Chris; Moons, Carl; de Wit, Ardine; Koffijberg, Erik

    2017-01-01

    Background: Although health economic evaluations (HEEs) are increasingly common for therapeutic interventions, they appear to be rare for the use of risk prediction models (PMs). Objectives: To evaluate the current state of HEEs of PMs by performing a comprehensive systematic review. Methods: Four

  13. Health economic evaluations in orthodontics: a systematic review.

    Science.gov (United States)

    Sollenius, Ola; Petrén, Sofia; Björnsson, Liselotte; Norlund, Anders; Bondemark, Lars

    2016-06-01

    Economic evaluation is assuming increasing importance as an integral component of health services research. To conduct a systematic review of the literature and assess the evidence from studies presenting orthodontic treatment outcomes and the related costs. The literature review was conducted in four steps, according to Goodman's model, in order to identify all studies evaluating economic aspects of orthodontic interventions. The search covered the databases Medline, Cinahl, Cochrane, Embase, Google Scholar, National Health Service Economic Evaluation Database, and SCOPUS, for the period from 1966 to September 2014. The inclusion criteria were as follows: randomized controlled trials or controlled clinical trials comparing at least two different orthodontic interventions, evaluation of both economic and orthodontic outcomes, and study populations of all ages. The quality of each included study was assessed as limited, moderate, or high. The overall evidence was assessed according to the GRADE system (The Grading of Recommendations Assessment, Development and Evaluation). The applied terms for searches yielded 1838 studies, of which 989 were excluded as duplicates. Application of the inclusion and exclusion criteria identified 26 eligible studies for which the full-text versions were retrieved and scrutinized. At the final analysis, eight studies remained. Three studies were based on cost-effectiveness analyses and the other five on cost-minimization analysis. Two of the cost-minimization studies included a societal perspective, i.e. the sum of direct and indirect costs. The aims of most of the studies varied widely and of studies comparing equivalent treatment methods, few were of sufficiently high study quality. Thus, the literature to date provides an inadequate evidence base for economic aspects of orthodontic treatment. This systematic review disclosed that few orthodontic studies have presented both economic and clinical outcomes. There is currently

  14. Systematic Evaluation of Uncertainty in Material Flow Analysis

    DEFF Research Database (Denmark)

    Laner, David; Rechberger, Helmut; Astrup, Thomas Fruergaard

    2014-01-01

    Material flow analysis (MFA) is a tool to investigate material flows and stocks in defined systems as a basis for resource management or environmental pollution control. Because of the diverse nature of sources and the varying quality and availability of data, MFA results are inherently uncertain....... Uncertainty analyses have received increasing attention in recent MFA studies, but systematic approaches for selection of appropriate uncertainty tools are missing. This article reviews existing literature related to handling of uncertainty in MFA studies and evaluates current practice of uncertainty analysis......) and exploratory MFA (identification of critical parameters and system behavior). Whereas mathematically simpler concepts focusing on data uncertainty characterization are appropriate for descriptive MFAs, statistical approaches enabling more-rigorous evaluation of uncertainty and model sensitivity are needed...

  15. Usability evaluation techniques in mobile commerce applications: A systematic review

    Science.gov (United States)

    Hussain, Azham; Mkpojiogu, Emmanuel O. C.

    2016-08-01

    Obviously, there are a number of literatures concerning the usability of mobile commerce (m-commerce) applications and related areas, but they do not adequately provide knowledge about usability techniques used in most of the empirical usability evaluation for m-commerce application. Therefore, this paper is aimed at producing the usability techniques frequently used in the aspect of usability evaluation for m-commerce applications. To achieve the stated objective, systematic literature review was employed. Sixty seven papers were downloaded in usability evaluation for m-commerce and related areas; twenty one most relevant studies were selected for review in order to extract the appropriate information. The results from the review shows that heuristic evaluation, formal test and think aloud methods are the most commonly used methods in m-commerce application in comparison to cognitive walkthrough and the informal test methods. Moreover, most of the studies applied control experiment (33.3% of the total studies); other studies that applied case study for usability evaluation are 14.28%. The results from this paper provide additional knowledge to the usability practitioners and research community for the current state and use of usability techniques in m-commerce application.

  16. Evaluation and impact of cardiotocography training programmes: a systematic review.

    Science.gov (United States)

    Pehrson, C; Sorensen, J L; Amer-Wåhlin, I

    2011-07-01

    The interpretation and management of cardiotocography (CTG) tracings are often criticised in obstetric malpractice cases. As a consequence, regular CTG training has been recommended, even though little is known about the effect of CTG training. To perform a systematic review of the existing literature on studies on CTG training in order to assess educational strategies, evaluation of training programmes, and impact of training programmes. The Medline database was searched to identify studies describing and/or evaluating CTG training programmes. The literature search resulted in 409 citations. Twenty studies describing and evaluating CTG training programmes were included. There was no restriction on study design. Data regarding study design, study quality, educational strategies used for training in CTG interpretation and decision making, target groups, number of participants, methods used for evaluation, quality of evaluation, level of evaluation and results of training was extracted from 20 articles, and analysed using Kirkpatrick's four-level model for the evaluation of education. Training was associated with improvements on all Kirkpatrick levels, resulting in increased CTG knowledge and interpretive skills, higher interobserver agreement, better management of intrapartum CTG, and improved quality of care. Computer-based training (CBT) might be less time-consuming than classroom teaching. Clinical skills seem to decrease faster than theoretical knowledge. Training can improve CTG competence and clinical practise. Further research on CBT, test-enhanced learning and long-term retention, evaluation of training and impact on clinical outcomes is recommended. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  17. Evaluation of Health Economics in Radiation Oncology: A Systematic Review

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Timothy K.; Goodman, Chris D. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Boldt, R. Gabriel [London Health Sciences Centre, London, Ontario (Canada); Warner, Andrew; Palma, David A. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Rodrigues, George B. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Lock, Michael I. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Mishra, Mark V. [Department of Radiation Oncology, University of Maryland, Baltimore, Maryland (United States); Zaric, Gregory S. [Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Ivey Business School, Western University, London, Ontario (Canada); Louie, Alexander V., E-mail: Dr.alexlouie@gmail.com [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada)

    2016-04-01

    Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions

  18. Evaluation of Health Economics in Radiation Oncology: A Systematic Review

    International Nuclear Information System (INIS)

    Nguyen, Timothy K.; Goodman, Chris D.; Boldt, R. Gabriel; Warner, Andrew; Palma, David A.; Rodrigues, George B.; Lock, Michael I.; Mishra, Mark V.; Zaric, Gregory S.; Louie, Alexander V.

    2016-01-01

    Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions

  19. Sleep disturbance in family caregivers of children who depend on medical technology: A systematic review.

    Science.gov (United States)

    Keilty, Krista; Cohen, Eyal; Ho, Michelle; Spalding, Karen; Stremler, Robyn

    2015-01-01

    Society relies on family caregivers of children who depend on medical technology (e.g. mechanical ventilation), to provide highly skilled and vigilant care in their homes 24 hours per day. Sleep disturbance is among the most common complaints of these caregivers. The purpose of this review is to systematically examine studies reporting on sleep outcomes in family caregivers of technology dependent children. All relevant databases were systematically searched: MEDLINE, EMBASE, PsycINFO and CINAHL. Given the heterogeneity of the studies, a qualitative analysis was completed and thus results of this review are presented as a narrative. Thirteen studies were retrieved that met eligibility criteria for inclusion. All of the studies reported on family caregivers of children with medical complexity living at home. Moreover, all of the studies relied entirely on self-report, not objective sleep measures. No intervention studies were found. Sleep disturbance was found to be common (51-100%) along with caregiver reports of poor sleep quality. Sleep quantity was seldom measured, but was found in the few studies that did, to be approximately 6 hours, or less than recommendations for optimal health and daytime function. Multiple caregiver, child and environmental factors were also identified that may negatively influence caregiver sleep, health and daytime function. Findings of this review suggest that family caregivers of children with medical complexity who depend on medical technology achieve poor sleep quality and quantity that may place them at risk of the negative consequences of sleep deprivation. Recommendations for practice include that health care providers routinely assess for sleep disturbance in this vulnerable population. The review also suggests that studies using objective sleep measurement are needed to more fully characterize sleep and inform the development of targeted interventions to promote sleep in family caregivers of technology dependent children.

  20. A systematic review of clinical supervision evaluation studies in nursing.

    Science.gov (United States)

    Cutcliffe, John R; Sloan, Graham; Bashaw, Marie

    2018-02-15

    According to the international, extant literature published during the last 20 years or so, clinical supervision (CS) in nursing is now a reasonably common phenomenon. Nevertheless, what appears to be noticeably 'thin on the ground' in this body of literature are empirical evaluations of CS, especially those pertaining to client outcomes. Accordingly, the authors undertook a systematic review of empirical evaluations of CS in nursing to determine the state of the science. Adopting the approach documented by Stroup et al. (JAMA, 283, 2000, 2008), the authors searched for reports of evaluation studies of CS in nursing - published during the years 1995 to 2015. Keywords for the search were 'clinical supervision', 'evaluation', 'efficacy', 'nursing', and combinations of these keywords. Electronic databases used were CINAHL, MEDLINE, PsychLIT, and the British Nursing Index. The research evidence from twenty-eight (28) studies reviewed is presented, outlining the main findings with an overview of each study presented. The following broad themes were identified and are each discussed in the study: narrative/anecdotal accounts of positive outcomes for clinical supervision, narrative/anecdotal accounts of negative outcomes for clinical supervision, empirical positive outcomes reported by supervisee, and empirical findings showing no effect by supervisee. © 2018 Australian College of Mental Health Nurses Inc.

  1. Cigarette smoking, nicotine dependence and anxiety disorders: a systematic review of population-based, epidemiological studies

    Directory of Open Access Journals (Sweden)

    Moylan Steven

    2012-10-01

    Full Text Available Abstract Background Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability exists in the epidemiological literature exploring this relationship, including study design (cross-sectional versus prospective, the population assessed (random sample versus clinical population and diagnostic instrument utilized. Methods We undertook a systematic review of population-based observational studies that utilized recognized structured clinical diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders (DSM or International Classification of Diseases (ICD for anxiety disorder diagnosis to investigate the relationship between cigarette smoking, nicotine dependence and anxiety disorders. Results In total, 47 studies met the predefined inclusion criteria, with 12 studies providing prospective information and 5 studies providing quasiprospective information. The available evidence suggests that some baseline anxiety disorders are a risk factor for initiation of smoking and nicotine dependence, although the evidence is heterogeneous and many studies did not control for the effect of comorbid substance use disorders. The identified evidence however appeared to more consistently support cigarette smoking and nicotine dependence as being a risk factor for development of some anxiety disorders (for example, panic disorder, generalized anxiety disorder, although these findings were not replicated in all studies. A number of inconsistencies in the literature were identified. Conclusions Although many studies have demonstrated increased rates of smoking and nicotine dependence in individuals with anxiety disorders, there is a limited and heterogeneous literature that has prospectively examined this relationship in population studies using validated diagnostic criteria. The most consistent evidence supports smoking and nicotine dependence as

  2. Systematic evaluation of nuclear operator team skills training

    International Nuclear Information System (INIS)

    Harrington, D.K.; Kello, J.E.

    1991-01-01

    In recent years, the nuclear industry has increasingly recognized with the technical training given its control room operators. As yet, however, little has been done to determine the actual effectiveness of such nontechnical training. Thus, the questions of how team training should be carried out for maximum impact on the safety and efficiency of control room operation and just what the benefits of such training might be remain open. We are in the early stages of establishing a systematic evaluation process that will help nuclear utilities assess the effectiveness of their existing team skills training programs for control room operators. Research focuses on defining the specific behavioral and attitudinal objectives of team skills training. Simply put, what does good practice look like and sound like in the control room environment? What specific behaviors and attitudes should the training be directed toward? Obviously, the answers to the questions have clear implications for the design of nuclear team skills training programs

  3. Lessons learned from NRC systematic evaluation program seismic review

    International Nuclear Information System (INIS)

    Cheng, T.M.; Hermann, R.A.; Russell, W.T.

    1983-01-01

    In October 1977, the Nuclear Regulatory Commission approved initiation of Phase II of the Systematic Evaluation Program (SEP) which consists of a plant-specific reassessment of the safety of 11 older operating nuclear reactors. Many safety criteria have rapidly evolved since the time of initial licensing of these plants. The purpose of the SEP is to develop a current documented basis for the safety of these older facilities by comparing them to current criteria. Phase I of the SEP developed a comprehensive list of 137 topics of safety significance which collectively affect the plant's capability to respond to various Design Basis Events (DBEs). Seismic Design Consideration is one of the 137 safety topics. (orig./GL)

  4. Systematic overview of economic evaluations of health-related rehabilitation.

    Science.gov (United States)

    Howard-Wilsher, Stephanie; Irvine, Lisa; Fan, Hong; Shakespeare, Tom; Suhrcke, Marc; Horton, Simon; Poland, Fiona; Hooper, Lee; Song, Fujian

    2016-01-01

    Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered. To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation. We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist. We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4). Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  5. Systematic corrosion investigation of various Cu-Sn alloys electrodeposited on mild steel in acidic solution: Dependence of alloy composition

    Energy Technology Data Exchange (ETDEWEB)

    Suerme, Yavuz, E-mail: ysurme@nigde.edu.t [Department of Chemistry, Faculty of Science and Art, Nigde University, 51200 Nigde (Turkey); Guerten, A. Ali [Department of Chemistry, Faculty of Science and Art, Osmaniye Korkut Ata University, 80000 Osmaniye (Turkey); Bayol, Emel; Ersoy, Ersay [Department of Chemistry, Faculty of Science and Art, Nigde University, 51200 Nigde (Turkey)

    2009-10-19

    Copper-tin alloy films were galvanostatically electrodeposited on the mild steel (MS) by combining the different amount of Cu and Sn electrolytes at a constant temperature (55 deg. C) and pH (3.5). Alloy films were characterized by using the energy dispersive X-ray analysis (EDX), scanning electron microscopy (SEM), X-ray diffraction (XRD) and micrographing techniques. Corrosion behaviours were evaluated with electrochemical impedance spectrometry (EIS) and electrochemical polarization measurements. Time gradient of electrolysis process was adjusted to obtain same thickness of investigated alloys on MS. The systematic corrosion investigation of various Cu{sub x}-Sn{sub 100-x} (x = 0-100) alloy depositions on MS substrate were carried out in 0.1 M sulphuric acid medium. Results indicate that the corrosion resistance of the alloy coatings depended on the alloy composition, and the corrosion resistance increased at Cu-Sn alloy deposits in proportion to Sn ratio.

  6. Approach for systematic evaluation of transuranic waste management alternatives

    International Nuclear Information System (INIS)

    Hong, K.; Koebnick, B.; Kotek, T.

    1994-01-01

    This paper describes an approach for systematic evaluation of management alternatives that are being considered for the treatment, storage, and disposal of transuranic waste (TRUW) at U.S. Department of Energy sites. The approach, which is currently under development, would apply WASTE-MGMT, a database application model developed at Argonne National Laboratory, to estimate projected environmental releases and would evaluate impact measures such as health risk and costs associated with each of the waste management alternatives. The customized application would combine site-specific TRUW inventory and characterization data with treatment and transportation parameters to estimate the quantities and characteristics of the wastes to be treated, emissions of hazardous substances from the treatment facilities, and the quantities and characteristics of the wastes to be shipped between sites. These data would then be used to estimate for several TRUW management scenarios the costs and health risks of constructing and operating the required treatment facilities and of transporting TRUW for treatment and final disposal. Treatment, storage, and disposal of TRUW at DOE sites is composed of many variables and options at each stage. The approach described in this paper would provide for efficient consideration of all of these facets when evaluating potentially feasible TRUW management alternatives. By expanding existing databases, this model could eventually be adapted to accommodate the introduction of new treatment technologies, updated TRUW characterization data, and/or revised waste acceptance criteria

  7. Meta-evaluation of published studies on evaluation of health disaster preparedness exercises through a systematic review.

    Science.gov (United States)

    Sheikhbardsiri, Hojjat; Yarmohammadian, Mohammad H; Khankeh, Hamid Reza; Nekoei-Moghadam, Mahmoud; Raeisi, Ahmad Reza

    2018-01-01

    Exercise evaluation is one of the most important steps and sometimes neglected in designing and taking exercises, in this stage of exercise, it systematically identifying, gathering, and interpreting related information to indicate how an exercise has fulfilled its objectives. The present study aimed to assess the most important evaluation techniques applied in evaluating health exercises for emergencies and disasters. This was meta-evaluation study through a systematic review. In this research, we searched papers based on specific and relevant keywords in research databases including ISI web of science, PubMed, Scopus, Science Direct, Ovid, ProQuest, Wiley, Google Scholar, and Persian database such as ISC and SID. The search keywords and strategies are followed; "simulation," "practice," "drill," "exercise," "instrument," "tool," "questionnaire," " measurement," "checklist," "scale," "test," "inventory," "battery," "evaluation," "assessment," "appraisal," "emergency," "disaster," "cricise," "hazard," "catastrophe,: "hospital", "prehospital," "health centers," "treatment centers," were used in combination with Boolean operators OR and AND. The research findings indicate that there are different techniques and methods for data collection to evaluate performance exercises of health centers and affiliated organizations in disasters and emergencies including debriefing inventories, self-report, questionnaire, interview, observation, shooting video, and photographing, electronic equipment which can be individually or collectively used depending on exercise objectives or purposes. Taking exercise in the health sector is one of the important steps in preparation and implementation of disaster risk management programs. This study can be thus utilized to improve preparedness of different sectors of health system according to the latest available evaluation techniques and methods for better implementation of disaster exercise evaluation stages.

  8. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    Energy Technology Data Exchange (ETDEWEB)

    Petrover, David [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Hopital Beaujon, Service de Radiologie, Paris (France); Schweitzer, Mark E. [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Laredo, J.D. [Hopital Lariboisiere, Service de Radiologie, Paris (France)

    2007-07-15

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  9. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    International Nuclear Information System (INIS)

    Petrover, David; Schweitzer, Mark E.; Laredo, J.D.

    2007-01-01

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  10. Financial evaluations of antibiotic stewardship programs - a systematic review

    Directory of Open Access Journals (Sweden)

    Jan-Willem Hendrik Dik

    2015-04-01

    Full Text Available IntroductionThere is an increasing awareness to counteract problems due to incorrect antimicrobial use. Interventions that are implemented are often part of an Antimicrobial Stewardship Program (ASPs. Studies publishing results from these interventions are increasing, including reports on the economical effects of ASPs. This review will look at the economical sections of these studies and the methods that were used. MethodsA systematic review was performed of articles found in the PubMed and EMBASE databases published from 2000 until November 2014. Included studies found were scored for various aspects and the quality of the papers was assessed following an appropriate check list (CHEC criteria list.Results1233 studies were found, of which 149 were read completely. 99 were included in the final review. Of these studies, 57 only mentioned the costs associated with the antimicrobial medication. Others also included operational costs (n=23, costs for hospital stay (n=18 and/or other costs (n=19. 9 studies were further assessed for their quality. These studies scored between 2 and 14 out of a potential total score of 19.ConclusionsThis review gives an extensive overview of the current financial evaluation of ASPs and the quality of these economical studies. We show that there is still major potential to improve financial evaluations of ASPs. Studies do not use similar nor consistent methods or outcome measures, making it impossible draw sound conclusions and compare different studies. Finally, we make some recommendations for the future.

  11. Systematic study of doping dependence on linear magnetoresistance in p-PbTe

    International Nuclear Information System (INIS)

    Schneider, J. M.; Chitta, V. A.; Oliveira, N. F.; Peres, M. L.; Castro, S. de; Soares, D. A. W.; Wiedmann, S.; Zeitler, U.; Abramof, E.; Rappl, P. H. O.; Mengui, U. A.

    2014-01-01

    We report on a large linear magnetoresistance effect observed in doped p-PbTe films. While undoped p-PbTe reveals a sublinear magnetoresistance, p-PbTe films doped with BaF 2 exhibit a transition to a nearly perfect linear magnetoresistance behaviour that is persistent up to 30 T. The linear magnetoresistance slope ΔR/ΔB is to a good approximation, independent of temperature. This is in agreement with the theory of Quantum Linear Magnetoresistance. We also performed magnetoresistance simulations using a classical model of linear magnetoresistance. We found that this model fails to explain the experimental data. A systematic study of the doping dependence reveals that the linear magnetoresistance response has a maximum for small BaF 2 doping levels and diminishes rapidly for increasing doping levels. Exploiting the huge impact of doping on the linear magnetoresistance signal could lead to new classes of devices with giant magnetoresistance behavior.

  12. Economic evaluation of emergency obstetric care training: a systematic review.

    Science.gov (United States)

    Banke-Thomas, Aduragbemi; Wilson-Jones, Megan; Madaj, Barbara; van den Broek, Nynke

    2017-12-04

    Training healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings. Peer-reviewed and grey literature was searched for relevant papers published after 1990. Studies were included if they described an economic evaluation of EmOC training and the training cost data were available. Two reviewers independently searched, screened, and selected studies that met the inclusion criteria, with disagreements resolved by a third reviewer. Quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards statement. For comparability, all costs in local currency were converted to International dollar (I$) equivalents using purchasing power parity conversion factors. The cost per training per participant was calculated. Narrative synthesis was used to summarise the available evidence on cost effectiveness. Fourteen studies (five full and nine partial economic evaluations) met the inclusion criteria. All five and two of the nine partial economic evaluations were of high quality. The majority of studies (13/14) were from low- and middle-income countries. Training equipment, per diems and resource person allowance were the most expensive components. Cost of training per person per day ranged from I$33 to I$90 when accommodation was required and from I$5 to I$21 when training was facility-based. Cost-effectiveness of training was assessed in 5 studies with differing measures of effectiveness (knowledge, skills, procedure cost and lives saved) making comparison difficult. Economic evaluations of EmOC training are limited. There is a

  13. Systematic review of model-based cervical screening evaluations.

    Science.gov (United States)

    Mendes, Diana; Bains, Iren; Vanni, Tazio; Jit, Mark

    2015-05-01

    Optimising population-based cervical screening policies is becoming more complex due to the expanding range of screening technologies available and the interplay with vaccine-induced changes in epidemiology. Mathematical models are increasingly being applied to assess the impact of cervical cancer screening strategies. We systematically reviewed MEDLINE®, Embase, Web of Science®, EconLit, Health Economic Evaluation Database, and The Cochrane Library databases in order to identify the mathematical models of human papillomavirus (HPV) infection and cervical cancer progression used to assess the effectiveness and/or cost-effectiveness of cervical cancer screening strategies. Key model features and conclusions relevant to decision-making were extracted. We found 153 articles meeting our eligibility criteria published up to May 2013. Most studies (72/153) evaluated the introduction of a new screening technology, with particular focus on the comparison of HPV DNA testing and cytology (n = 58). Twenty-eight in forty of these analyses supported HPV DNA primary screening implementation. A few studies analysed more recent technologies - rapid HPV DNA testing (n = 3), HPV DNA self-sampling (n = 4), and genotyping (n = 1) - and were also supportive of their introduction. However, no study was found on emerging molecular markers and their potential utility in future screening programmes. Most evaluations (113/153) were based on models simulating aggregate groups of women at risk of cervical cancer over time without accounting for HPV infection transmission. Calibration to country-specific outcome data is becoming more common, but has not yet become standard practice. Models of cervical screening are increasingly used, and allow extrapolation of trial data to project the population-level health and economic impact of different screening policy. However, post-vaccination analyses have rarely incorporated transmission dynamics. Model calibration to country

  14. Systematic comparison of position and time dependent macroparticle simulations in beam dynamics studies

    Directory of Open Access Journals (Sweden)

    Ji Qiang

    2002-06-01

    Full Text Available Macroparticle simulation plays an important role in modern accelerator design and operation. Most linear rf accelerators have been designed based on macroparticle simulations using longitudinal position as the independent variable. In this paper, we have done a systematic comparison between using longitudinal position as the independent variable and using time as the independent variable in macroparticle simulations. We have found that, for an rms-matched beam, the maximum relative moment difference for second, fourth moments and beam maximum amplitudes between these two types of simulations is 0.25% in a 10 m reference transport system with physical parameters similar to the Spallation Neutron Source linac design. The maximum z-to- t transform error in the space-charge force calculation of the position dependent simulation is about 0.1% in such a system. This might cause a several percent error in a complete simulation of a linac with a length of hundreds of meters. Furthermore, the error may be several times larger in simulations of mismatched beams. However, if such errors are acceptable to the linac designer, then one is justified in using position dependent macroparticle simulations in this type of linac design application.

  15. A Systematic Review of Economic Evaluations of Pacemaker Telemonitoring Systems.

    Science.gov (United States)

    López-Villegas, Antonio; Catalán-Matamoros, Daniel; Martín-Saborido, Carlos; Villegas-Tripiana, Irene; Robles-Musso, Emilio

    2016-02-01

    Over the last decade, telemedicine applied to pacemaker monitoring has undergone extraordinary growth. It is not known if telemonitoring is more or less efficient than conventional monitoring. The aim of this study was to carry out a systematic review analyzing the available evidence on resource use and health outcomes in both follow-up modalities. We searched 11 databases and included studies published up until November 2014. The inclusion criteria were: a) experimental or observational design; b) studies based on complete economic evaluations; c) patients with pacemakers, and d) telemonitoring compared with conventional hospital monitoring. Seven studies met the inclusion criteria, providing information on 2852 patients, with a mean age of 81 years. The main indication for device implantation was atrioventricular block. With telemonitoring, cardiovascular events were detected and treated 2 months earlier than with conventional monitoring, thus reducing length of hospital stay by 34% and reducing routine and emergency hospital visits as well. There were no significant intergroup differences in perceived quality of life or number of adverse events. The cost of telemonitoring was 60% lower than that of conventional hospital monitoring. Compared with conventional monitoring, cardiovascular events were detected earlier and the number or hospitalizations and hospital visits was reduced with pacemaker telemonitoring. In addition, the costs associated with follow-up were lower with telemonitoring. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  16. Evaluating the core microbiota in complex communities: A systematic investigation.

    Science.gov (United States)

    Astudillo-García, Carmen; Bell, James J; Webster, Nicole S; Glasl, Bettina; Jompa, Jamaluddin; Montoya, Jose M; Taylor, Michael W

    2017-04-01

    The study of complex microbial communities poses unique conceptual and analytical challenges, with microbial species potentially numbering in the thousands. With transient or allochthonous microorganisms often adding to this complexity, a 'core' microbiota approach, focusing only on the stable and permanent members of the community, is becoming increasingly popular. Given the various ways of defining a core microbiota, it is prudent to examine whether the definition of the core impacts upon the results obtained. Here we used complex marine sponge microbiotas and undertook a systematic evaluation of the degree to which different factors used to define the core influenced the conclusions. Significant differences in alpha- and beta-diversity were detected using some but not all core definitions. However, findings related to host specificity and environmental quality were largely insensitive to major changes in the core microbiota definition. Furthermore, none of the applied definitions altered our perception of the ecological networks summarising interactions among bacteria within the sponges. These results suggest that, while care should still be taken in interpretation, the core microbiota approach is surprisingly robust, at least for comparing microbiotas of closely related samples. © 2017 Society for Applied Microbiology and John Wiley & Sons Ltd.

  17. Digital pathology: A systematic evaluation of the patent landscape

    Directory of Open Access Journals (Sweden)

    Ioan C. Cucoranu

    2014-01-01

    Full Text Available Introduction: Digital pathology is a relatively new field. Inventors of technology in this field typically file for patents to protect their intellectual property. An understanding of the patent landscape is crucial for companies wishing to secure patent protection and market dominance for their products. To our knowledge, there has been no prior systematic review of patents related to digital pathology. Therefore, the aim of this study was to systematically identify and evaluate United States patents and patent applications related to digital pathology. Materials and Methods: Issued patents and patent applications related to digital pathology published in the United States Patent and Trademark Office (USPTO database (www.uspto.gov (through January 2014 were searched using the Google Patents search engine (Google Inc., Mountain View, California, USA. Keywords and phrases related to digital pathology, whole-slide imaging (WSI, image analysis, and telepathology were used to query the USPTO database. Data were downloaded and analyzed using the Papers application (Mekentosj BV, Aalsmeer, Netherlands. Results: A total of 588 United States patents that pertain to digital pathology were identified. In addition, 228 patent applications were identified, including 155 that were pending, 65 abandoned, and eight rejected. Of the 588 patents granted, 348 (59.18% were specific to pathology, while 240 (40.82% included more general patents also usable outside of pathology. There were 70 (21.12% patents specific to pathology and 57 (23.75% more general patents that had expired. Over 120 unique entities (individual inventors, academic institutions, and private companies applied for pathology specific patents. Patents dealt largely with telepathology and image analysis. WSI related patents addressed image acquisition (scanning and focus, quality (z-stacks, management (storage, retrieval, and transmission of WSI files, and viewing (graphical user interface (GUI

  18. Digital pathology: A systematic evaluation of the patent landscape.

    Science.gov (United States)

    Cucoranu, Ioan C; Parwani, Anil V; Vepa, Suryanarayana; Weinstein, Ronald S; Pantanowitz, Liron

    2014-01-01

    Digital pathology is a relatively new field. Inventors of technology in this field typically file for patents to protect their intellectual property. An understanding of the patent landscape is crucial for companies wishing to secure patent protection and market dominance for their products. To our knowledge, there has been no prior systematic review of patents related to digital pathology. Therefore, the aim of this study was to systematically identify and evaluate United States patents and patent applications related to digital pathology. Issued patents and patent applications related to digital pathology published in the United States Patent and Trademark Office (USPTO) database (www.uspto.gov) (through January 2014) were searched using the Google Patents search engine (Google Inc., Mountain View, California, USA). Keywords and phrases related to digital pathology, whole-slide imaging (WSI), image analysis, and telepathology were used to query the USPTO database. Data were downloaded and analyzed using the Papers application (Mekentosj BV, Aalsmeer, Netherlands). A total of 588 United States patents that pertain to digital pathology were identified. In addition, 228 patent applications were identified, including 155 that were pending, 65 abandoned, and eight rejected. Of the 588 patents granted, 348 (59.18%) were specific to pathology, while 240 (40.82%) included more general patents also usable outside of pathology. There were 70 (21.12%) patents specific to pathology and 57 (23.75%) more general patents that had expired. Over 120 unique entities (individual inventors, academic institutions, and private companies) applied for pathology specific patents. Patents dealt largely with telepathology and image analysis. WSI related patents addressed image acquisition (scanning and focus), quality (z-stacks), management (storage, retrieval, and transmission of WSI files), and viewing (graphical user interface (GUI), workflow, slide navigation and remote control). An

  19. Economic evaluation studies in reproductive medicine: a systematic review of methodologic quality

    NARCIS (Netherlands)

    Moolenaar, Lobke M.; Vijgen, Sylvia M. C.; Hompes, Peter; van der Veen, Fulco; Mol, Ben Willem J.; Opmeer, Brent C.

    2013-01-01

    To evaluate the methodologic quality of economic analyses published in the field of reproductive medicine. Systematic review. Centers for reproductive care. Infertility patients. We performed a Medline search to identify economic evaluation studies in reproductive medicine. We included studies that

  20. Clinical diagnostic evaluation for scaphoid fractures: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Mallee, Wouter H.; Henny, Erik P.; van Dijk, C. Niek; Kamminga, Sjoerd P.; van Enst, Wynanda A.; Kloen, Peter

    2014-01-01

    To provide an overview of available clinical evaluation tests for scaphoid fractures and to compare their diagnostic accuracies. PWe performed a systematic review of all studies assessing diagnostic characteristics of clinical evaluation in scaphoid fractures by searching MEDLINE, EMBASE, Cochrane,

  1. Systematic evaluation of candidate blood markers for detecting ovarian cancer.

    Directory of Open Access Journals (Sweden)

    Chana Palmer

    2008-07-01

    Full Text Available Epithelial ovarian cancer is a significant cause of mortality both in the United States and worldwide, due largely to the high proportion of cases that present at a late stage, when survival is extremely poor. Early detection of epithelial ovarian cancer, and of the serous subtype in particular, is a promising strategy for saving lives. The low prevalence of ovarian cancer makes the development of an adequately sensitive and specific test based on blood markers very challenging. We evaluated the performance of a set of candidate blood markers and combinations of these markers in detecting serous ovarian cancer.We selected 14 candidate blood markers of serous ovarian cancer for which assays were available to measure their levels in serum or plasma, based on our analysis of global gene expression data and on literature searches. We evaluated the performance of these candidate markers individually and in combination by measuring them in overlapping sets of serum (or plasma samples from women with clinically detectable ovarian cancer and women without ovarian cancer. Based on sensitivity at high specificity, we determined that 4 of the 14 candidate markers--MUC16, WFDC2, MSLN and MMP7--warrant further evaluation in precious serum specimens collected months to years prior to clinical diagnosis to assess their utility in early detection. We also reported differences in the performance of these candidate blood markers across histological types of epithelial ovarian cancer.By systematically analyzing the performance of candidate blood markers of ovarian cancer in distinguishing women with clinically apparent ovarian cancer from women without ovarian cancer, we identified a set of serum markers with adequate performance to warrant testing for their ability to identify ovarian cancer months to years prior to clinical diagnosis. We argued for the importance of sensitivity at high specificity and of magnitude of difference in marker levels between cases and

  2. Evaluation of Stock Management Strategies Reliability at Dependent Demand

    Directory of Open Access Journals (Sweden)

    Lukinskiy Valery

    2017-03-01

    Full Text Available For efficiently increasing the logistic systems, the core specialists’ attention has to be directed to reducing costs and increasing supply chains reliability. A decent attention to costs reduction has already been paid, so it can be stated that in this way there is a significant progress. But the problem of reliability evaluation is still insufficiently explored, particularly, in such an important sphere as inventory management at the dependent demand.

  3. The relevance of the psychological evaluation in drug dependence

    OpenAIRE

    Popescu, G; Negrei, C; B?l?l?u, D; Ciobanu, AM; Baconi, D

    2014-01-01

    Psychological interventions are considered a central part of the individual psychotherapy in the rehabilitation counseling of psychiatrically symptomatic drug-dependent patients during methadone maintenance treatment in community programs. The need for psychological counseling should be evaluated for each individual patient. Medication is an important part of the treatment and individual psychotherapy focuses on the reduction or total cessation of drug use. The Recipient is G.M. 31, sentenced...

  4. Annotation of the Evaluative Language in a Dependency Treebank

    Directory of Open Access Journals (Sweden)

    Šindlerová Jana

    2017-12-01

    Full Text Available In the paper, we present our efforts to annotate evaluative language in the Prague Dependency Treebank 2.0. The project is a follow-up of the series of annotations of small plaintext corpora. It uses automatic identification of potentially evaluative nodes through mapping a Czech subjectivity lexicon to syntactically annotated data. These nodes are then manually checked by an annotator and either dismissed as standing in a non-evaluative context, or confirmed as evaluative. In the latter case, information about the polarity orientation, the source and target of evaluation is added by the annotator. The annotations unveiled several advantages and disadvantages of the chosen framework. The advantages involve more structured and easy-to-handle environment for the annotator, visibility of syntactic patterning of the evaluative state, effective solving of discontinuous structures or a new perspective on the influence of good/bad news. The disadvantages include little capability of treating cases with evaluation spread among more syntactically connected nodes at once, little capability of treating metaphorical expressions, or disregarding the effects of negation and intensification in the current scheme.

  5. Performance Evaluation of Bluetooth Low Energy: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Jacopo Tosi

    2017-12-01

    Full Text Available Small, compact and embedded sensors are a pervasive technology in everyday life for a wide number of applications (e.g., wearable devices, domotics, e-health systems, etc.. In this context, wireless transmission plays a key role, and among available solutions, Bluetooth Low Energy (BLE is gaining more and more popularity. BLE merges together good performance, low-energy consumption and widespread diffusion. The aim of this work is to review the main methodologies adopted to investigate BLE performance. The first part of this review is an in-depth description of the protocol, highlighting the main characteristics and implementation details. The second part reviews the state of the art on BLE characteristics and performance. In particular, we analyze throughput, maximum number of connectable sensors, power consumption, latency and maximum reachable range, with the aim to identify what are the current limits of BLE technology. The main results can be resumed as follows: throughput may theoretically reach the limit of ~230 kbps, but actual applications analyzed in this review show throughputs limited to ~100 kbps; the maximum reachable range is strictly dependent on the radio power, and it goes up to a few tens of meters; the maximum number of nodes in the network depends on connection parameters, on the network architecture and specific device characteristics, but it is usually lower than 10; power consumption and latency are largely modeled and analyzed and are strictly dependent on a huge number of parameters. Most of these characteristics are based on analytical models, but there is a need for rigorous experimental evaluations to understand the actual limits.

  6. Undiscovered resource evaluation: Towards applying a systematic approach to uranium

    International Nuclear Information System (INIS)

    Fairclough, M.; Katona, L.

    2014-01-01

    Evaluations of potential mineral resource supply range from spatial to aspatial, and everything in between across a range of scales. They also range from qualitative to quantitative with similar hybrid examples across the spectrum. These can compromise detailed deposit-specific reserve and resource calculations, target generative processes and estimates of potential endowments in a broad geographic or geological area. All are estimates until the ore has been discovered and extracted. Contemporary national or provincial scale evaluations of mineral potential are relatively advanced and some include uranium, such as those for South Australia undertaken by the State Geological Survey. These play an important role in land-use planning as well as attracting exploration investment and range from datato knowledge-driven approaches. Studies have been undertaken for the Mt Painter region, as well as for adjacent basins. The process of estimating large-scale potential mineral endowments is critical for national and international planning purposes but is a relatively recent and less common undertaking. In many cases, except at a general level, the data and knowledge for a relatively immature terrain is lacking, requiring assessment by analogy with other areas. Commencing in the 1980s, the United States Geological Survey, and subsequently the Geological Survey of Canada evaluated a range of commodities ranging from copper to hydrocarbons with a view to security of supply. They developed innovative approaches to, as far as practical, reduce the uncertainty and maximise the reproducibility of the calculations in information-poor regions. Yet the approach to uranium was relatively ad hoc and incomplete (such as the US Department of Energy NURE project). Other historic attempts, such as the IAEA-NEA International Uranium Resource Evaluation Project (IUREP) in the 1970s, were mainly qualitative. While there is still no systematic global evaluation of undiscovered uranium resources

  7. Systematic measurements of opacity dependence on temperature, density, and atomic number at stellar interior conditions

    Science.gov (United States)

    Nagayama, Taisuke

    2017-10-01

    Model predictions for iron opacity are notably different from measurements performed at matter conditions similar to the boundary between the solar radiation and convection zones. The calculated iron opacities have narrower spectral lines, weaker quasi-continuum at short wavelength, and deeper opacity windows than the measurements. If correct, these measurements help resolve a decade old problem in solar physics. A key question is therefore: What is responsible for the model-data discrepancy? The answer is complex because the experiments are challenging and opacity theories depend on multiple entangled physical processes such as the influence of completeness and accuracy of atomic states, line broadening, contributions from myriad transitions from excited states, and multi-photon absorption processes. To help determine the cause of this discrepancy, a systematic study of opacity variation with temperature, density, and atomic number is underway. Measurements of chromium, iron, and nickel opacities have been performed at two different temperatures and densities. The collection of measured opacities provides constraints on hypotheses to explain the discrepancy. We will discuss implications of measured opacities, experimental errors, and possible opacity model refinements. Sandia National Laboratories is a multi-mission laboratory managed and operated by National Technology and Engineering Solutions of Sandia, LLC., a wholly owned subsidiary of Honeywell International, Inc., for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA0003525.

  8. Measuring nuclear-spin-dependent parity violation with molecules: Experimental methods and analysis of systematic errors

    Science.gov (United States)

    Altuntaş, Emine; Ammon, Jeffrey; Cahn, Sidney B.; DeMille, David

    2018-04-01

    Nuclear-spin-dependent parity violation (NSD-PV) effects in atoms and molecules arise from Z0 boson exchange between electrons and the nucleus and from the magnetic interaction between electrons and the parity-violating nuclear anapole moment. It has been proposed to study NSD-PV effects using an enhancement of the observable effect in diatomic molecules [D. DeMille et al., Phys. Rev. Lett. 100, 023003 (2008), 10.1103/PhysRevLett.100.023003]. Here we demonstrate highly sensitive measurements of this type, using the test system 138Ba19F. We show that systematic errors associated with our technique can be suppressed to at least the level of the present statistical sensitivity. With ˜170 h of data, we measure the matrix element W of the NSD-PV interaction with uncertainty δ W /(2 π )<0.7 Hz for each of two configurations where W must have different signs. This sensitivity would be sufficient to measure NSD-PV effects of the size anticipated across a wide range of nuclei.

  9. Digital integrated protection system: Quantitative methods for dependability evaluation

    International Nuclear Information System (INIS)

    Krotoff, H.; Benski, C.

    1986-01-01

    The inclusion of programmed digital techniques in the SPIN system provides the used with the capability of performing sophisticated processing operations. However, it causes the quantitative evaluation of the overall failure probabilities to become somewhat more intricate by reason that: A single component may be involved in several functions; Self-tests may readily be incorporated for the purpose of monitoring the dependable operation of the equipment at all times. This paper describes the methods as implemented by MERLIN GERIN for the purpose of evaluating: The probabilities for the protective actions not to be initiated (dangerous failures); The probabilities for such protective actions to be initiated accidentally. Although the communication is focused on the programmed portion of the SPIN (UAIP) it will also deal with the evaluation performed within the scope of study works that do not exclusively cover the UAIPs

  10. Effects of flaxseed and Hypericum perforatum on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women: a systematic review and meta-analysis

    Science.gov (United States)

    Ghazanfarpour, Masumeh; Sadeghi, Ramin; Latifnejad Roudsari, Robab; Khadivzadeh, Talat; khorsand, Imaneh; Afiat, Maliheh; Esmaeilizadeh, Mahdi

    2016-01-01

    Objective: In this study, we aimed at evaluation of the efficacy of Hypericum perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women Materials and Methods: We searched MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials (RCT) to explore trials that assessed the effectiveness of H. perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers. In this regard, the following terms were used “menopause AND H. perforatum OR flaxseed OR Linum usitatissimum. Only randomized controlled trials were included in the study. Results: Nine RCTs were included in this systematic review. Based on the literature, flaxseed showed beneficial effect on hot flash frequency and intensity, which was not statistically significant. According to two trials, flaxseed showed estrogenic effects; however, no conclusion regarding cancer promoting or protecting effects can be made. The evidence of the efficacy of the flaxseed on alleviating vaginal atrophy was also limited due to inconsistent findings in this regard. One trial declared that Vitex agnus-castus and H. perforatum showed comparable decrease in the frequency of hot flashes. Conclusion: The results of our systematic review suggest beneficial effect on vasomotor symptom with both of flaxseed and H. perforatum. Consistent conclusion regarding estrogen-dependent cancers and maturation value is limited due to small number of trials related to flaxseed. Further trials are still needed to confirm the results of our systematic review. PMID:27462550

  11. Effects of flaxseed and Hypericum perforatum on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women: a systematic review and meta-analysis.

    Science.gov (United States)

    Ghazanfarpour, Masumeh; Sadeghi, Ramin; Latifnejad Roudsari, Robab; Khadivzadeh, Talat; Khorsand, Imaneh; Afiat, Maliheh; Esmaeilizadeh, Mahdi

    2016-01-01

    In this study, we aimed at evaluation of the efficacy of Hypericum perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women. We searched MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials (RCT) to explore trials that assessed the effectiveness of H. perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers. In this regard, the following terms were used "menopause AND H. perforatum OR flaxseed OR Linum usitatissimum. Only randomized controlled trials were included in the study. Nine RCTs were included in this systematic review. Based on the literature, flaxseed showed beneficial effect on hot flash frequency and intensity, which was not statistically significant. According to two trials, flaxseed showed estrogenic effects; however, no conclusion regarding cancer promoting or protecting effects can be made. The evidence of the efficacy of the flaxseed on alleviating vaginal atrophy was also limited due to inconsistent findings in this regard. One trial declared that Vitex agnus-castus and H. perforatum showed comparable decrease in the frequency of hot flashes. The results of our systematic review suggest beneficial effect on vasomotor symptom with both of flaxseed and H. perforatum. Consistent conclusion regarding estrogen-dependent cancers and maturation value is limited due to small number of trials related to flaxseed. Further trials are still needed to confirm the results of our systematic review.

  12. A systematic review of economic evaluations of cardiac rehabilitation

    Directory of Open Access Journals (Sweden)

    Wong Wai

    2012-08-01

    Full Text Available Abstract Background Cardiac rehabilitation (CR, a multidisciplinary program consisting of exercise, risk factor modification and psychosocial intervention, forms an integral part of managing patients after myocardial infarction (MI, revascularization surgery and percutaneous coronary interventions, as well as patients with heart failure (HF. This systematic review seeks to examine the cost-effectiveness of CR for patients with MI or HF and inform policy makers in Singapore on published cost-effectiveness studies on CR. Methods Electronic databases (EMBASE, MEDLINE, NHS EED, PEDro, CINAHL were searched from inception to May 2010 for published economic studies. Additional references were identified through searching bibliographies of included studies. Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Quality assessment of economic evaluations was undertaken using Drummond’s checklist. Results A total of 22 articles were selected for review. However five articles were further excluded because they were cost-minimization analyses, whilst one included patients with stroke. Of the final 16 articles, one article addressed both centre-based cardiac rehabilitation versus no rehabilitation, as well as home-based cardiac rehabilitation versus no rehabilitation. Therefore, nine studies compared cost-effectiveness between centre-based supervised CR and no CR; three studies examined that between centre- and home based CR; one between inpatient and outpatient CR; and four between home-based CR and no CR. These studies were characterized by differences in the study perspectives, economic study designs and time frames, as well as variability in clinical data and assumptions made on costs. Overall, the studies suggested that: (1 supervised centre-based CR was highly cost-effective and the dominant strategy when compared to no CR; (2 home-based CR was no different from centre-based CR; (3 no difference existed

  13. Process variables in organizational stress management intervention evaluation research: a systematic review

    NARCIS (Netherlands)

    Havermans, B.M.; Schelvis, R.M.C.; Boot, C.R.L.; Brouwers, E.P.M.; Anema, J.R.; Beek, A.J. van der

    2016-01-01

    Objectives This systematic review aimed to explore which process variables are used in stress management intervention (SMI) evaluation research. Methods A systematic review was conducted using seven electronic databases. Studies were included if they reported on an SMI aimed at primary or secondary

  14. Process variables in organizational stress management intervention evaluation research : A systematic review

    NARCIS (Netherlands)

    Havermans, B.M.; Schlevis, Roosmarijn Mc; Boot, Cécile Rl; Brouwers, E.P.M.; Anema, Johannes R; van der Beek, Allard J

    2016-01-01

    OBJECTIVES: This systematic review aimed to explore which process variables are used in stress management intervention (SMI) evaluation research. METHODS: A systematic review was conducted using seven electronic databases. Studies were included if they reported on an SMI aimed at primary or

  15. Effects of Ayahuasca and its Alkaloids on Drug Dependence: A Systematic Literature Review of Quantitative Studies in Animals and Humans.

    Science.gov (United States)

    Nunes, Amanda A; Dos Santos, Rafael G; Osório, Flávia L; Sanches, Rafael F; Crippa, José Alexandre S; Hallak, Jaime E C

    2016-01-01

    Recently, the anti-addictive potential of ayahuasca, a dimethyltryptamine(DMT)- and β-carboline-rich hallucinogenic beverage traditionally used by indigenous groups of the Northwest Amazon and currently by syncretic churches worldwide, has received increased attention. To better evaluate this topic, we performed a systematic literature review using the PubMed database to find quantitative studies (using statistical analysis) that assessed the effects of ayahuasca or its components in drug-related symptoms or disorders. We found five animal studies (using harmaline, harmine, or ayahuasca) and five observational studies of regular ayahuasca consumers. All animal studies showed improvement of biochemical or behavioral parameters related to drug-induced disorders. Of the five human studies, four reported significant reductions of dependence symptoms or substance use, while one did not report significant results. The mechanisms responsible for the anti-addictive properties of ayahuasca and its alkaloids are not clarified, apparently involving both peripheral MAO-A inhibition by the β-carbolines and central agonism of DMT at 5-HT2A receptors expressed in brain regions related to the regulation of mood and emotions. Although results are promising, controlled studies are needed to replicate these preliminary findings.

  16. The relevance of the psychological evaluation in drug dependence.

    Science.gov (United States)

    Popescu, G; Negrei, C; Bălălău, D; Ciobanu, A M; Baconi, D

    2014-01-01

    Psychological interventions are considered a central part of the individual psychotherapy in the rehabilitation counseling of psychiatrically symptomatic drug-dependent patients during methadone maintenance treatment in community programs. The need for psychological counseling should be evaluated for each individual patient. Medication is an important part of the treatment and individual psychotherapy focuses on the reduction or total cessation of drug use. The Recipient is G.M. 31, sentenced to a seven-year term of imprisonment for trafficking and use of and high-risk drugs, diagnosed on admission with opioid and methadone dependence, withdrawal syndrome. Following the observation and psychological evaluation, psychiatric and clinical examination, initiation of methadone substitution treatment was recommended, according to the following regimen: twelve 2.5 mg tablets for the first 2 days, followed by increase with about 5 mg per week until the complete remission of withdrawal symptoms, stabilization of the dose but not exceeding 200 mg methadone hydrochloride per day. Specialist monitoring, specialized counseling and individual and group psychotherapy were provided.

  17. Systematization of simplified J-integral evaluation method for flaw evaluation at high temperature

    International Nuclear Information System (INIS)

    Miura, Naoki; Takahashi, Yukio; Nakayama, Yasunari; Shimakawa, Takashi

    2000-01-01

    J-integral is an effective inelastic fracture parameter for the flaw evaluation of cracked components at high temperature. The evaluation of J-integral for an arbitrary crack configuration and an arbitrary loading condition can be generally accomplished by detailed numerical analysis such as finite element analysis, however, it is time-consuming and requires a high degree of expertise for its implementation. Therefore, it is important to develop simplified J-integral estimation techniques from the viewpoint of industrial requirements. In this study, a simplified J-integral evaluation method is proposed to estimate two types of J-integral parameters. One is the fatigue J-integral range to describe fatigue crack propagation behavior, and the other is the creep J-integral to describe creep crack propagation behavior. This paper presents the systematization of the simplified J-integral evaluation method incorporated with the reference stress method and the concept of elastic follow-up, and proposes a comprehensive evaluation procedure. The verification of the proposed method is presented in Part II of this paper. (author)

  18. Systematic evaluation program status summary report: November 1-30, 1981

    International Nuclear Information System (INIS)

    1981-12-01

    The Systematic Evaluation Program is intended to examine many safety related aspects of eleven of the older light water reactors. This document provides the existing status of the review process including individual topic and overall completion status

  19. A systematic review evaluating the impact of task shifting on access ...

    African Journals Online (AJOL)

    A systematic review evaluating the impact of task shifting on access to antiretroviral therapy in sub-Saharan Africa. ... Background: Task shifting, defined for this review as the shifting of ART initiation and ... AJOL African Journals Online.

  20. Systematic Differences Across Evaluation Schemes and Educational Choice

    DEFF Research Database (Denmark)

    Rangvid, Beatrice Schindler

    2015-01-01

    Using large-scale register data from Denmark in a difference-in-differences framework, I analyse whether systematic disparities between internal teacher scores and external exam scores in the school-leaving certificates are linked to pupil characteristics. Such differences may mat- ter for post......-school. The corresponding increase for pupils with low educated parents is 4% points, closing 13% of the high-school enrolment gap to pupils with high educated parents....

  1. Systematic Differences across Evaluation Schemes and Educational Choice

    DEFF Research Database (Denmark)

    Rangvid, Beatrice Schindler

    Using large scale register data from Denmark in a difference-in-differences framework, I analyze whether systematic disparities between internal teacher scores and external exam scores in the school leaving certificates are linked to pupil characteristics. Such differences may be particularly con......-SES pupils’ predicted probability to enroll in high-school, closing almost 10% of the high-school enrolment gap to high-SES pupils. Increases for boys and migrant pupils are modest....

  2. Time-dependent methodology for fault tree evaluation

    International Nuclear Information System (INIS)

    Vesely, W.B.

    1976-01-01

    Any fault tree may be evaluated applying the method called the kinetic theory of fault trees. The basic feature of this method as presented here is in that any information on primary failure, type failure or peak failure is derived from three characteristics: probability of existence, failure intensity and failure density. The determination of the said three characteristics for a given phenomenon yields the remaining probabilistic information on the individual aspects of the failure and on their totality for the whole observed period. The probabilistic characteristics are determined by applying the analysis of phenomenon probability. The total time dependent information on the peak failure is obtained by using the type failures (critical paths) of the fault tree. By applying the said process the total time dependent information is obtained for every primary failure and type failure of the fault tree. In the application of the method of the kinetic theory of fault trees represented by the PREP and KITT programmes, the type failures are first obtained using the deterministic testing method or using the Monte Carlo simulation (PREP programme). The respective characteristics are then determined using the kinetic theory of fault trees (KITT programmes). (Oy)

  3. Systematic errors in the readings of track etch neutron dosemeters caused by the energy dependence of response

    International Nuclear Information System (INIS)

    Tanner, R.J.; Thomas, D.J.; Bartlett, D.T.; Horwood, N.

    1999-01-01

    A study has been performed to assess the extent to which variations in the energy dependence of response of neutron personal dosemeters can cause systematic errors in readings obtained in workplace fields. This involved a detailed determination of the response functions of personal dosemeters used in the UK. These response functions were folded with workplace spectra to ascertain the under- or over-response in workplace fields

  4. Systematic errors in the readings of track etch neutron dosemeters caused by the energy dependence of response

    CERN Document Server

    Tanner, R J; Bartlett, D T; Horwood, N

    1999-01-01

    A study has been performed to assess the extent to which variations in the energy dependence of response of neutron personal dosemeters can cause systematic errors in readings obtained in workplace fields. This involved a detailed determination of the response functions of personal dosemeters used in the UK. These response functions were folded with workplace spectra to ascertain the under- or over-response in workplace fields.

  5. A systematic review of factors influencing student ratings in undergraduate medical education course evaluations.

    Science.gov (United States)

    Schiekirka, Sarah; Raupach, Tobias

    2015-03-05

    Student ratings are a popular source of course evaluations in undergraduate medical education. Data on the reliability and validity of such ratings have mostly been derived from studies unrelated to medical education. Since medical education differs considerably from other higher education settings, an analysis of factors influencing overall student ratings with a specific focus on medical education was needed. For the purpose of this systematic review, online databases (PubMed, PsycInfo and Web of Science) were searched up to August 1st, 2013. Original research articles on the use of student ratings in course evaluations in undergraduate medical education were eligible for inclusion. Included studies considered the format of evaluation tools and assessed the association of independent and dependent (i.e., overall course ratings) variables. Inclusion and exclusion criteria were checked by two independent reviewers, and results were synthesised in a narrative review. Twenty-five studies met the inclusion criteria. Qualitative research (2 studies) indicated that overall course ratings are mainly influenced by student satisfaction with teaching and exam difficulty rather than objective determinants of high quality teaching. Quantitative research (23 studies) yielded various influencing factors related to four categories: student characteristics, exposure to teaching, satisfaction with examinations and the evaluation process itself. Female gender, greater initial interest in course content, higher exam scores and higher satisfaction with exams were associated with more positive overall course ratings. Due to the heterogeneity and methodological limitations of included studies, results must be interpreted with caution. Medical educators need to be aware of various influences on student ratings when developing data collection instruments and interpreting evaluation results. More research into the reliability and validity of overall course ratings as typically used in the

  6. Operating experience review for nuclear power plants in the Systematic Evaluation Program

    International Nuclear Information System (INIS)

    Mays, G.T.; Harrington, K.H.

    1982-01-01

    The Systematic Evaluation Program Branch (SEPB) of the Nuclear Regulatory Commission (NRC) is conducting the Systematic Evaluation Program (SEP) whose purpose is to determine the safety margins of the design and operation of the eleven oldest operating commercial nuclear power plants in the United States. This paper describes the methodology and results of the operational experience review portion of the SEP evaluation. SEPB will combine the results from these operational reviews with other safety topic evaluations to perform an integrated assessment of the SEP plants

  7. Systematic evaluation of clinical practice guidelines for pharmacogenomics.

    Science.gov (United States)

    Beckett, Robert D; Kisor, David F; Smith, Thomas; Vonada, Brooke

    2018-06-01

    To systematically assess methodological quality of pharmacogenomics clinical practice guidelines. Guidelines published through 2017 were reviewed by at least three independent reviewers using the AGREE II instrument, which consists of 23 items grouped into 6 domains and 2 items representing an overall assessment. Items were assessed on a seven-point rating scale, and aggregate quality scores were calculated. 31 articles were included. All guidelines were published as peer-reviewed articles and 90% (n = 28) were endorsed by professional organizations. Mean AGREE II domain scores (maximum score 100%) ranged from 46.6 ± 11.5% ('applicability') to 78.9 ± 11.4% ('clarity of presentation'). Median overall quality score was 72.2% (IQR: 61.1-77.8%). Quality of pharmacogenomics guidelines was generally high, but variable, for most AGREE II domains.

  8. Hydroxyurea for nontransfusion-dependent β-thalassemia: A systematic review and meta-analysis.

    Science.gov (United States)

    Algiraigri, Ali H; Wright, Nicola A M; Paolucci, Elizabeth Oddone; Kassam, Aliya

    2017-09-01

    Nontransfusion-dependent β-thalassemia (NTDβT) syndromes consist of β-thalassemia intermedia and moderate hemoglobin E/β thalassemias. They are characterized by varying degrees of chronic anemia and a wide spectrum of complications due to ineffective erythropoiesis and iron overload from chronic transfusions. Hydroxyurea (HU), an oral chemotherapeutic drug, is anticipated to decrease disease severity. We performed a meta-analysis to evaluate the clinical efficacy and safety of HU in NTDβT patients of any age. MEDLINE, EMBASE, Cochrane databases, and major conference proceedings for studies that assessed HU in NTDβT patients were searched. Qualities of eligible studies were assessed by National Institutes of Health tools. Seventeen studies, collectively involving 709 patients, fulfilled the eligibility criteria. HU was associated with a significant decrease in transfusion need in severe NTDβT with complete and overall (≥50%) response rates of 42% and 79%, respectively. For mild NTDβT, HU was effective in raising hemoglobin by 1g/L in 64% of patients. HU appears to be effective, well tolerated, and associated with mild and transient adverse events. NTDβT patients may benefit from a trial of HU, although large randomized clinical trials assessing its efficacy should be conducted to confirm the findings of this meta-analysis and to assess its long-term toxicity and response sustainability. Copyright © 2017 King Faisal Specialist Hospital & Research Centre. Published by Elsevier B.V. All rights reserved.

  9. Mapping the absolute magnetic field and evaluating the quadratic Zeeman-effect-induced systematic error in an atom interferometer gravimeter

    Science.gov (United States)

    Hu, Qing-Qing; Freier, Christian; Leykauf, Bastian; Schkolnik, Vladimir; Yang, Jun; Krutzik, Markus; Peters, Achim

    2017-09-01

    Precisely evaluating the systematic error induced by the quadratic Zeeman effect is important for developing atom interferometer gravimeters aiming at an accuracy in the μ Gal regime (1 μ Gal =10-8m /s2 ≈10-9g ). This paper reports on the experimental investigation of Raman spectroscopy-based magnetic field measurements and the evaluation of the systematic error in the gravimetric atom interferometer (GAIN) due to quadratic Zeeman effect. We discuss Raman duration and frequency step-size-dependent magnetic field measurement uncertainty, present vector light shift and tensor light shift induced magnetic field measurement offset, and map the absolute magnetic field inside the interferometer chamber of GAIN with an uncertainty of 0.72 nT and a spatial resolution of 12.8 mm. We evaluate the quadratic Zeeman-effect-induced gravity measurement error in GAIN as 2.04 μ Gal . The methods shown in this paper are important for precisely mapping the absolute magnetic field in vacuum and reducing the quadratic Zeeman-effect-induced systematic error in Raman transition-based precision measurements, such as atomic interferometer gravimeters.

  10. Systematic shifts of evaluated charge centroid for the cathode read-out multiwire proportional chamber

    International Nuclear Information System (INIS)

    Endo, I.; Kawamoto, T.; Mizuno, Y.; Ohsugi, T.; Taniguchi, T.; Takeshita, T.

    1981-01-01

    We have investigated the systematic error associtated with the charge centroid evaluation for the cathode read-out multiwire proportional chamber. Correction curves for the systematic error according to six centroid finding algorithms have been obtained by using the charge distribution calculated in a simple electrostatic mode. They have been experimentally examined and proved to be essential for the accurate determination of the irradiated position. (orig.)

  11. Evaluating clinical ethics support in mental healthcare: a systematic literature review.

    NARCIS (Netherlands)

    Hem, M.H.; Pedersen, R.; Norvoll, R.; Molewijk, A.C.

    2015-01-01

    A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five

  12. Systematic Evaluation of Aggressive Air Sampling for Bacillus ...

    Science.gov (United States)

    Report The primary objectives of this project were to evaluate the Aggressive Air Sampling (AAS) method compared to currently used surface sampling methods and to determine if AAS is a viable option for sampling Bacillus anthracis spores.

  13. Regulatory licensing, status summary report; Systematic evaluation program

    International Nuclear Information System (INIS)

    1978-01-01

    This document is part of a management information system presenting a logical flow of events that represent the evaluation of 11 of the older operating nuclear reactors. Information collected will be used to determine the degree to which the 11 plants meet current licensing requirements and to develop an overall balanced position concerning any needed backfitting of the facilities and the documentation of the results of such evaluations

  14. Effects of flaxseed and Hypericum perforatum on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Masumeh Ghazanfarpour

    2016-04-01

    Conclusion: The results of our systematic review suggest beneficial effect on vasomotor symptom with both of flaxseed and H. perforatum. Consistent conclusion regarding estrogen-dependent cancers and maturation value is limited due to small number of trials related to flaxseed. Further trials are still needed to confirm the results of our systematic review.

  15. [Function of the present systematic evaluation in establishment of guidance for clinical practice].

    Science.gov (United States)

    Yang, Jin-Hong; Hu, Jing; Yang, Feng-Chun; Zhang, Ning; Wang, Bing; Li, Xin

    2012-07-01

    Treatment of insomnia with acupuncture is taken as an example to explore the significance and problems existed in the present systematic evaluation in establishment of guidance for clinical practice. Fifteen articles on systematic evaluation of both English and Chinese were retrieved and studied carefully, their basic information was analyzed. Through study on the establishing process of the guidance of clinical practice, researches were focused on the possible significance of the articles to the guidance as well as the notes in the reuse of those articles since problem still existed. It is held that the systematic evaluation has great significance on the establishment of the guidance from the aspects of applicable people, recommended standards of diagnosis and therapeutic evaluation, extended recommendation and methodology. Great importance should also be attached to the direct application of the research result and understanding of the evaluation result. The data should be rechecked when necessary. Great guiding function can be found on the systematic evaluation of articles to the guidance. Moreover, if information needed to be taken into a full play, specific analysis should also be done on the concrete research targets.

  16. On writing legibly: Processing fluency systematically biases evaluations of handwritten material

    OpenAIRE

    Greifeneder, Rainer; Alt, Alexander; Bottenberg, Konstantin; Seele, Tim; Zelt, Sarah; Wagener, Dietrich

    2010-01-01

    Evaluations of handwritten essays or exams are often suspected of being biased, such as by mood states or individual predilections. Although most of these influences are unsystematic, at least one bias is problematic because it systematically affects evaluations of handwritten materials. Three experiments revealed that essays in legible as compared to less legible handwriting were evaluated more positively. This robust finding was related to a basic judgmental mechanism that builds on the flu...

  17. ERESYE - a expert system for the evaluation of uncertainties related to systematic experimental errors

    International Nuclear Information System (INIS)

    Martinelli, T.; Panini, G.C.; Amoroso, A.

    1989-11-01

    Information about systematic errors are not given In EXFOR, the data base of nuclear experimental measurements: their assessment is committed to the ability of the evaluator. A tool Is needed which performs this task in a fully automatic way or, at least, gives a valuable aid. The expert system ERESYE has been implemented for investigating the feasibility of an automatic evaluation of the systematic errors in the experiments. The features of the project which led to the implementation of the system are presented. (author)

  18. A systematic review of COTS evaluation and selection approaches

    Directory of Open Access Journals (Sweden)

    Rakesh Garg

    2017-11-01

    Full Text Available In the past decades, a number of researchers have made their significant contributions to develop different approaches for solving a very challenging problem of commercial off-the shelf (COTS selection. The development of software with high quality and minimum development time has always been a difficult job for the software developers. Therefore, in today’s scenario, software developers move towards the implementation of component based software engineering that relies on the integration of small pieces of code namely (COTS. In this study, we present a comprehensive descriptive explanation of the various COTS evaluation and selection approaches developed by various researchers in the past to understand the concept of COTS selection. The advantages and disadvantages of each COTS selection approach are also provided, which will give a better prospect to the readers to understand the various existing COTS evaluation and selection approaches.

  19. Environmental scan and evaluation of best practices for online systematic review resources.

    Science.gov (United States)

    Parker, Robin M N; Boulos, Leah M; Visintini, Sarah; Ritchie, Krista; Hayden, Jill

    2018-04-01

    Online training for systematic review methodology is an attractive option due to flexibility and limited availability of in-person instruction. Librarians often direct new reviewers to these online resources, so they should be knowledgeable about the variety of available resources. The objective for this project was to conduct an environmental scan of online systematic review training resources and evaluate those identified resources. The authors systematically searched for electronic learning resources pertaining to systematic review methods. After screening for inclusion, we collected data about characteristics of training resources and assigned scores in the domains of (1) content, (2) design, (3) interactivity, and (4) usability by applying a previously published evaluation rubric for online instruction modules. We described the characteristics and scores for each training resource and compared performance across the domains. Twenty training resources were evaluated. Average overall score of online instructional resources was 61%. Online courses (n=7) averaged 73%, web modules (n=5) 64%, and videos (n=8) 48%. The top 5 highest scoring resources were in course or web module format, featured high interactivity, and required a longer (>5hrs) time commitment from users. This study revealed that resources include appropriate content but are less likely to adhere to principles of online training design and interactivity. Awareness of these resources will allow librarians to make informed recommendations for training based on patrons' needs. Future online systematic review training resources should use established best practices for e-learning to provide high-quality resources, regardless of format or user time commitment.

  20. Evaluating nicotine dependence levels in e-cigarette users.

    Science.gov (United States)

    González Roz, Alba; Secades Villa, Roberto; Weidberg, Sara

    2017-01-11

    Despite the fact that electronic cigarettes (e-cigarettes) are rapidly growing in popularity and use worldwide, there is scarce scientific data on abuse liability among e-cigarette users, and about whether e-cigarette use is related to nicotine dependence or not. The aim of this study is to explore nicotine dependence levels in a sample of experienced e-cigarette users (n= 39) and to compare them with current tobacco cigarette smokers (n=42). We conducted several face-to-face interviews in order to assess sociodemographic and dependence related characteristics in both e-cigarette users and in smokers. Adapted versions of both the Fagerström test for nicotine dependence (FTND) and the nicotine dependence syndrome scale (NDSS) were used to analyze nicotine dependence in each of the groups. Biochemical markers of carbon monoxide and urinary cotinine analysis were also collected. Results showed that e-cigarette users scored lower than cigarette smokers in both FTND and all NDSS subscales. Our findings extend previous research on e-cigarette use and nicotine addiction and suggest that e-cigarette users are less dependent on nicotine than current tobacco cigarette smokers. Further prospective studies are needed to better ascertain their addictiveness potential, comparing those smokers who switched to e-cigarettes from smoking cigarettes, and those who had never been tobacco cigarette smokers.

  1. User Experience Evaluations in Rehabilitation Video Games for Children: A Systematic Mapping of the Literature.

    Science.gov (United States)

    Rico-Olarte, Carolina; López, Diego M; Blobel, Bernd; Kepplinger, Sara

    2017-01-01

    In recent years, the interest in user experience (UX) evaluation methods for assessing technology solutions, especially in health systems for children with special needs like cognitive disabilities, has increased. Conduct a systematic mapping study to provide an overview in the field of UX evaluations in rehabilitation video games for children. The definition of research questions, the search for primary studies and the extraction of those studies by inclusion and exclusion criteria lead to the mapping of primary papers according to a classification scheme. Main findings from this study include the detection of the target population of the selected studies, the recognition of two different ways of evaluating UX: (i) user evaluation and (ii) system evaluation, and UX measurements and devices used. This systematic mapping specifies the research gaps identified for future research works in the area.

  2. Evaluation of Time-Dependent Behavior of Soils

    DEFF Research Database (Denmark)

    Augustesen, Anders; Liingaard, Morten; Lade, Poul V.

    2004-01-01

    The time-dependent behavior of soils has been investigated extensively through one-dimensional and triaxial test conditions. Most of the observations in literature have focused on the determination of the time-dependent behavior of clayey soils, whereas the reported experimental studies of granular...... situation for soils. That is whether the time-dependent behavior can be characterized as isotach or nonisotach. It seems that the isotach behavior is adequate for describing the time effects in clays in most situations. But for sand, the isotach description is inadequate. Further, the phenomenon...

  3. Methods for systematic reviews of health economic evaluations: a systematic review, comparison, and synthesis of method literature.

    Science.gov (United States)

    Mathes, Tim; Walgenbach, Maren; Antoine, Sunya-Lee; Pieper, Dawid; Eikermann, Michaela

    2014-10-01

    The quality of systematic reviews of health economic evaluations (SR-HE) is often limited because of methodological shortcomings. One reason for this poor quality is that there are no established standards for the preparation of SR-HE. The objective of this study is to compare existing methods and suggest best practices for the preparation of SR-HE. To identify the relevant methodological literature on SR-HE, a systematic literature search was performed in Embase, Medline, the National Health System Economic Evaluation Database, the Health Technology Assessment Database, and the Cochrane methodology register, and webpages of international health technology assessment agencies were searched. The study selection was performed independently by 2 reviewers. Data were extracted by one reviewer and verified by a second reviewer. On the basis of the overlaps in the recommendations for the methods of SR-HE in the included papers, suggestions for best practices for the preparation of SR-HE were developed. Nineteen relevant publications were identified. The recommendations within them often differed. However, for most process steps there was some overlap between recommendations for the methods of preparation. The overlaps were taken as basis on which to develop suggestions for the following process steps of preparation: defining the research question, developing eligibility criteria, conducting a literature search, selecting studies, assessing the methodological study quality, assessing transferability, and synthesizing data. The differences in the proposed recommendations are not always explainable by the focus on certain evaluation types, target audiences, or integration in the decision process. Currently, there seem to be no standard methods for the preparation of SR-HE. The suggestions presented here can contribute to the harmonization of methods for the preparation of SR-HE. © The Author(s) 2014.

  4. The equity dimension in evaluations of the quality and outcomes framework: a systematic review.

    Science.gov (United States)

    Boeckxstaens, Pauline; Smedt, Delphine De; Maeseneer, Jan De; Annemans, Lieven; Willems, Sara

    2011-08-31

    Pay-for-performance systems raise concerns regarding inequity in health care because providers might select patients for whom targets can easily be reached. This paper aims to describe the evolution of pre-existing (in)equity in health care in the period after the introduction of the Quality and Outcomes Framework (QOF) in the UK and to describe (in)equities in exception reporting. In this evaluation, a theory-based framework conceptualising equity in terms of equal access, equal treatment and equal treatment outcomes for people in equal need is used to guide the work. A systematic MEDLINE and Econlit search identified 317 studies. Of these, 290 were excluded because they were not related to the evaluation of QOF, they lacked an equity dimension in the evaluation, their qualitative research focused on experiences or on the nature of the consultation, or unsuitable methodology was used to pronounce upon equity after the introduction of QOF. None of the publications (n = 27) assessed equity in access to health care. Concerning equity in treatment and (intermediate) treatment outcomes, overall quality scores generally improved. For the majority of the observed indicators, all citizens benefit from this improvement, yet the extent to which different patient groups benefit tends to vary and to be highly dependent on the type and complexity of the indicator(s) under study, the observed patient group(s) and the characteristics of the study. In general, the introduction of QOF was favourable for the aged and for males. Total QOF scores did not seem to vary according to ethnicity. For deprivation, small but significant residual differences were observed after the introduction of QOF favouring less deprived groups. These differences are mainly due to differences at the practice level. The variance in exception reporting according to gender and socio-economic position is low. Although QOF seems not to be socially selective at first glance, this does not mean QOF does not

  5. The equity dimension in evaluations of the quality and outcomes framework: A systematic review

    Directory of Open Access Journals (Sweden)

    Annemans Lieven

    2011-08-01

    Full Text Available Abstract Background Pay-for-performance systems raise concerns regarding inequity in health care because providers might select patients for whom targets can easily be reached. This paper aims to describe the evolution of pre-existing (inequity in health care in the period after the introduction of the Quality and Outcomes Framework (QOF in the UK and to describe (inequities in exception reporting. In this evaluation, a theory-based framework conceptualising equity in terms of equal access, equal treatment and equal treatment outcomes for people in equal need is used to guide the work. Methods A systematic MEDLINE and Econlit search identified 317 studies. Of these, 290 were excluded because they were not related to the evaluation of QOF, they lacked an equity dimension in the evaluation, their qualitative research focused on experiences or on the nature of the consultation, or unsuitable methodology was used to pronounce upon equity after the introduction of QOF. Results None of the publications (n = 27 assessed equity in access to health care. Concerning equity in treatment and (intermediate treatment outcomes, overall quality scores generally improved. For the majority of the observed indicators, all citizens benefit from this improvement, yet the extent to which different patient groups benefit tends to vary and to be highly dependent on the type and complexity of the indicator(s under study, the observed patient group(s and the characteristics of the study. In general, the introduction of QOF was favourable for the aged and for males. Total QOF scores did not seem to vary according to ethnicity. For deprivation, small but significant residual differences were observed after the introduction of QOF favouring less deprived groups. These differences are mainly due to differences at the practice level. The variance in exception reporting according to gender and socio-economic position is low. Conclusions Although QOF seems not to be socially

  6. Analysis of dependent failures in risk assessment and reliability evaluation

    International Nuclear Information System (INIS)

    Fleming, K.N.; Mosleh, A.; Kelley, A.P. Jr.; Gas-Cooled Reactors Associates, La Jolla, CA)

    1983-01-01

    The ability to estimate the risk of potential reactor accidents is largely determined by the ability to analyze statistically dependent multiple failures. The importance of dependent failures has been indicated in recent probabilistic risk assessment (PRA) studies as well as in reports of reactor operating experiences. This article highlights the importance of several different types of dependent failures from the perspective of the risk and reliability analyst and provides references to the methods and data available for their analysis. In addition to describing the current state of the art, some recent advances, pitfalls, misconceptions, and limitations of some approaches to dependent failure analysis are addressed. A summary is included of the discourse on this subject, which is presented in the Institute of Electrical and Electronics Engineers/American Nuclear Society PRA Procedures Guide

  7. Systematic evaluation of observational methods assessing biomechanical exposures at work

    DEFF Research Database (Denmark)

    Takala, Esa-Pekka; Irmeli, Pehkonen; Forsman, Mikael

    2009-01-01

    by sorting the methods according to the several items evaluated.   Numerous methods have been developed to assess physical workload (biomechanical exposures) in order to identify hazards leading to musculoskeletal disorders, to monitor the effects of ergonomic changes, and for research. No indvidual method...... between observers Potential users NIOSH Lifting Eq. NA X - O, R Arbouw M - - O ACGIH Lifting TLV M - - O MAC - - M O, W(?) ManTRA - - - O, R(?),W(?) NZ Code for MH - - - O, W(?) Washington state ergonomic rule M X M O, W(?) BackEST ML - M R   Correspondence with valid reference: HM = High to moderate, L......), and Washington state model. MAC (UK), ManTRA (Australia), and New Zealand code are widely used for the assessment of risks in MMH but we did not found formal studies on validity of these methods. The inter-observer repeatability of MAC and the Washington state model has been found to be moderate. Back...

  8. Reactive endplate marrow changes: a systematic morphologic and epidemiologic evaluation

    International Nuclear Information System (INIS)

    Karchevsky, Michael; Schweitzer, Mark E.; Carrino, John A.; Zoga, Adam; Montgomery, Douglas; Parker, Laurence

    2005-01-01

    To evaluate the morphology and location of vertebral endplate changes, and to analyze their association with age, gender, and body mass index (BMI). At 1.5 T (T1-weighted, T2-weighted/STIR) 100 lumbar spines were evaluated separately by three observers. The readers classified the endplate bone marrow abnormalities on sagittal MR images according to the definitions of Modic et al. Findings were localized by disc segment; whether in the upper and/or lower endplate; and within each endplate divided into 15 segments. Disc space narrowing, as well as disc desiccation, was also noted at each vertebral level. In addition, endplate changes were correlated with age, gender, and BMI (weight(kg)/height(m) 2 ). A total of 15,000 data points were studied and 422 total changes recorded. A total of 99 vertebral levels were affected in 58 patients. Of these, 171 were of type I, 242 were of type II, and 9 were of type III. L4 - L5 and L5 - S1 vertebral levels were most commonly involved, having (142, 4.73%) and (116, 3.87%) changes respectively (P<0.0001). The upper and lower aspects of the endplate were affected similarly. Changes most frequently occurred at the anterior aspect of the endplate (P<0.0001). Endplate marrow changes were associated with increasing age (P<0.0001) and, surprisingly, male gender (P<0.0001). Endplate changes were not associated with BMI. The fatty pattern was most common, with the sclerotic pattern being rare. Endplate marrow changes most often occurred at the anterior aspect of the endplate, particularly at L4 - L5 and L5 - S1 levels. Modic changes occur more frequently with aging, evidence of their degenerative etiology. They were, however, not related to body habitus, but to weight and male gender. (orig.)

  9. Reactive endplate marrow changes: a systematic morphologic and epidemiologic evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Karchevsky, Michael [Hahnemann University Hospital, Department of Radiology, Philadelphia (United States); Thomas Jefferson University Hospital, Department of Radiology, Philadelphia (United States); Schweitzer, Mark E. [Hospital for Joint Diseases, Department of Radiology, New York (United States); Carrino, John A.; Zoga, Adam; Montgomery, Douglas; Parker, Laurence [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia (United States)

    2005-03-01

    To evaluate the morphology and location of vertebral endplate changes, and to analyze their association with age, gender, and body mass index (BMI). At 1.5 T (T1-weighted, T2-weighted/STIR) 100 lumbar spines were evaluated separately by three observers. The readers classified the endplate bone marrow abnormalities on sagittal MR images according to the definitions of Modic et al. Findings were localized by disc segment; whether in the upper and/or lower endplate; and within each endplate divided into 15 segments. Disc space narrowing, as well as disc desiccation, was also noted at each vertebral level. In addition, endplate changes were correlated with age, gender, and BMI (weight(kg)/height(m){sup 2}). A total of 15,000 data points were studied and 422 total changes recorded. A total of 99 vertebral levels were affected in 58 patients. Of these, 171 were of type I, 242 were of type II, and 9 were of type III. L4 - L5 and L5 - S1 vertebral levels were most commonly involved, having (142, 4.73%) and (116, 3.87%) changes respectively (P<0.0001). The upper and lower aspects of the endplate were affected similarly. Changes most frequently occurred at the anterior aspect of the endplate (P<0.0001). Endplate marrow changes were associated with increasing age (P<0.0001) and, surprisingly, male gender (P<0.0001). Endplate changes were not associated with BMI. The fatty pattern was most common, with the sclerotic pattern being rare. Endplate marrow changes most often occurred at the anterior aspect of the endplate, particularly at L4 - L5 and L5 - S1 levels. Modic changes occur more frequently with aging, evidence of their degenerative etiology. They were, however, not related to body habitus, but to weight and male gender. (orig.)

  10. Commissioning of the double Penning trap system MLLTRAP and first studies on mass-dependent systematic uncertainties

    Energy Technology Data Exchange (ETDEWEB)

    Krug, Kevin; Weber, Christine; Thirolf, Peter G.; Szerypo, Jerzy; Gartzke, Eva; Habs, Dietrich [Fakultaet fuer Physik, LMU Muenchen (Germany); Kolhinen, Veli [Fakultaet fuer Physik, LMU Muenchen (Germany); Department of Physics, University of Jyvaeskylae (Finland)

    2010-07-01

    The cylindrical double Penning trap system MLLTRAP in its commissioning phase at the Maier-Leibnitz-Laboratory (MLL) Tandem accelerator in Garching is designed to perform high-accuracy mass measurements on fusion-reaction products. As the mass uncertainty is inversely proportional to the ionic charge state, the ions of interest will be charge bred prior to injection into the Penning trap system. In the future setup, both traps are foreseen to be operated as measurement traps with a relative homogeneity of the magnetic field at the trapping sites of {delta}B/B{<=}0.3 ppm. In the commissioning phase, an offline surface ionization source is used for iterative optimization of the apparatus and studies on mass-dependent systematic uncertainties. Mass measurements via the time-of-flight ion cyclotron resonance method (TOF-ICR) of reference ions with well-known masses ({sup 85}Rb, {sup 87}Rb, {sup 39}K, {sup 133}Cs) were carried out to analyze mass-dependent systematic effects. Together with previous studies on the uncertainty due to magnetic-field fluctuations the current status with respect to the limits of mass accuracy of the apparatus is presented.

  11. Systematic reviews in Library and Information Science: analysis and evaluation of the search process

    Directory of Open Access Journals (Sweden)

    José Antonio Salvador-Oliván

    2018-05-01

    Full Text Available Objective: An essential component of a systematic review is the development and execution of a literature search to identify all available and relevant published studies. The main objective of this study is to analyse and evaluate whether the systematic reviews in Library and Information Science (LIS provide complete information on all the elements that make up the search process. Methods: A search was launched in WOS, Scopus, LISTA, Library Science Database, Medline databases and a wiki published from 2000 to February 2017, in order to find and identify systematic reviews. The search was designed to find those records whose titles included the words “systematic review” and/or “meta-analysis”. A list was created with the twelve items recommended from of the main publication guides, to assess the information degree on each of them. Results and conclusions: Most of the reviews in LIS are created by information professionals. From the 94 systematic reviews selected for analysis, it was found that only a 4.3% provided the complete reporting on the search method. The most frequently included item is the name of the database (95.6% and the least one is the name of the host (35.8%. It is necessary to improve and complete the information about the search processes in the complete reports from LIS systematic reviews for reproducibility, updating and quality assessment improvement.

  12. Systematic evaluation of prompt neutron spectra in fission

    International Nuclear Information System (INIS)

    Osawa, Takaaki

    1995-01-01

    To create the nuclear data fail JEND-32, the prompt fission neutron spectra X(E) of 233 U, 235 U, 238 U and 239 Pu were reevaluated and some improvement were added to the calculation models. We tried to extend the calculation method of fission spectra of nuclides with poor measurement data in consideration of increasing the importance of nuclear data of minor actinoids. We improved and extended the following five points. (1) On JENDL-3.1, the fission spectra of principal fissible materials had been calculated by the Modland-Nix model which the neutron emissions of fragments were calculated under the approximation of the constant inverse process cross section. In the paper, the spectra were calculated by the use of the inverse process cross section depend on the energy obtained by the calculation of the optical model. The result showed the increase of low energy components and the softening effect of spectra (2) On JENDL-3.1, the all fission processes were assumed to undergo (n,f) reaction. In the paper, they were calculated by the multi-chance fission such as (n, n'f), (n, 2nf) and (n, 3nf) etc. Softening of the spectra (En > 6 MeV) was obtained by this method. (3) The level density parameter (LDP) has been assumed as a = A/C in either case of light fragment (LF) and heavy fragment (HF) in the original Madland-Nix model. But we used LDP based on the Ignatyuk model under consideration of the shell effects of nuclear fragments, hence the neutron spectra of heavy fragments were hardening. (4) Nuclear temperature of both fragments had been assumed to be the same at original model, but now R T = Tm/TmH was derived to calculate them. The ratio of middle/both side components of spectra was changed. (5) Unknown neutron fission spectra of minor actinide were able to the assumed on the basis of Moriyama-Ohnishi model. (S.Y.)

  13. The Design, Implementation, and Evaluation of Online Credit Nutrition Courses: A Systematic Review

    Science.gov (United States)

    Cohen, Nancy L.; Carbone, Elena T.; Beffa-Negrini, Patricia A.

    2011-01-01

    Objective: To assess how postsecondary online nutrition education courses (ONEC) are delivered, determine ONEC effectiveness, identify theoretical models used, and identify future research needs. Design: Systematic search of database literature. Setting: Postsecondary education. Participants: Nine research articles evaluating postsecondary ONEC.…

  14. Evaluation of a new method for librarian-mediated literature searches for systematic reviews

    NARCIS (Netherlands)

    W.M. Bramer (Wichor); Rethlefsen, M.L. (Melissa L.); F. Mast (Frans); J. Kleijnen (Jos)

    2017-01-01

    textabstractObjective: To evaluate and validate the time of completion and results of a new method of searching for systematic reviews, the exhaustive search method (ESM), using a pragmatic comparison. Methods: Single-line search strategies were prepared in a text document. Term completeness was

  15. Measuring Health Literacy in Individuals with Diabetes: A Systematic Review and Evaluation of Available Measures

    Science.gov (United States)

    Al Sayah, Fatima; Williams, Beverly; Johnson, Jeffrey A.

    2013-01-01

    Objective: To identify instruments used to measure health literacy and numeracy in people with diabetes; evaluate their use, measurement scope, and properties; discuss their strengths and weaknesses; and propose the most useful, reliable, and applicable measure for use in research and practice settings. Methods" A systematic literature review…

  16. Fatigue in patients with low grade glioma: systematic evaluation of assessment and prevalence

    NARCIS (Netherlands)

    E.M.P. Van Coevorden-van Loon (Ellen M. P.); Coomans, M.B. (Marijke B.); M.H. Heijenbrok-Kal (Majanka); G.M. Ribbers (Gerard); M.J. van den Bent (Martin)

    2017-01-01

    textabstractFatigue is the most prevalent and disabling symptom in cancer patients. Yet, scientific literature on this topic is scarce and reports disparate results. This study systematically reviews how fatigue is assessed in patients with low-grade glioma and evaluates its prevalence in LGG

  17. A Systematic Approach to Process Evaluation in the Central Oklahoma Turning Point (COTP) Partnership

    Science.gov (United States)

    Tolma, Eleni L.; Cheney, Marshall K.; Chrislip, David D.; Blankenship, Derek; Troup, Pam; Hann, Neil

    2011-01-01

    Formation is an important stage of partnership development. Purpose: To describe the systematic approach to process evaluation of a Turning Point initiative in central Oklahoma during the formation stage. The nine-month collaborative effort aimed to develop an action plan to promote health. Methods: A sound planning framework was used in the…

  18. Techniques to Evaluate Dental Erosion: A Systematic Review of Literature.

    Science.gov (United States)

    Joshi, Mahasweta; Joshi, Nikhil; Kathariya, Rahul; Angadi, Prabhakar; Raikar, Sonal

    2016-10-01

    This article reviews different techniques for evaluating dental erosion, weighs the advantages and disadvantages of these techniques, and presents the latest trends in the study of dental erosion. In May 2014, an initial search was carried out in the PubMed/MEDLINE database of indexed journals from 1975 to 2013 using the following keywords: dental erosion; dental erosion In-vitro; and dental erosion in-vivo. Bibliographic citations from the papers found were then used to find other useful sources. The authors categorize the techniques into three classes: in-vitro, in-vivo and in-vitro/in-vivo. The article discusses the instrumentation required to use each of these techniques, as well as their rationale, merits and applications. The emergence of in-vitro/in-vivo techniques offers the potential to accurately quantify tooth wear in clinical situations. Cross-sectional as well as longitudinal studies show that these techniques will improve diagnosis, treatment planning and management of dental erosion.

  19. An integrated approach for the systematic evaluation of polymeric nanoparticles in healthy and diseased organisms

    Science.gov (United States)

    Sitia, Leopoldo; Paolella, Katia; Romano, Michela; Violatto, Martina Bruna; Ferrari, Raffaele; Fumagalli, Stefano; Colombo, Laura; Bello, Ezia; De Simoni, Maria Grazia; D'Incalci, Maurizio; Morbidelli, Massimo; Erba, Eugenio; Salmona, Mario; Moscatelli, Davide; Bigini, Paolo

    2014-07-01

    Innovative strategies that utilize nanoparticles (NPs) for a better delivery of drugs and to improve their therapeutic efficacy have been widely studied in many clinical fields, including oncology. To develop safe and reliable devices able to reach their therapeutic target, a hierarchical characterization of NP interactions with biological fluids, cells, and whole organisms is fundamental. Unfortunately, this aspect is often neglected and the development of standardized characterization methods would be of fundamental help to better elucidate the potentials of nanomaterials, even before the loading of the drugs. Here, we propose a multimodal in vitro/in vivo/ex vivo platform aimed at evaluating these interactions for the selection of the most promising NPs among a wide series of materials. To set the system, we used non-degradable fluorescent poly(methyl-methacrylate) NPs of different sizes (50, 100, and 200 nm) and surface charges (positive and negative). First we studied NP stability in biological fluids. Then, we evaluated NP interaction with two cell lines of triple-negative breast cancer (TNBC), 4T1, and MDA-MB231.1833, respectively. We found that NPs internalize in TNBC cells depending on their physico-chemical properties without toxic effects. Finally, we studied NP biodistribution in terms of tissue migration and progressive clearance in breast-cancer bearing mice. The use of highly stable poly(methyl-methacrylate) NPs enabled us to track them for a long time in cells and animals. The application of this platform to other nanomaterials could provide innovative suggestions for the development of a systematic method of characterization to select the most reliable nanodrug candidates for biomedical applications.

  20. Systematic dependence on the slowing down environment, of nuclear lifetime measurements by DSAM

    International Nuclear Information System (INIS)

    Toulemonde, M.; Haas, F.

    1976-01-01

    The meanlife of the 22 Ne 3.34MeV level measured by DSAM (Doppler Shift Attenuation Method) at an average velocity of 0.009 c, shows large fluctuations with different slowing down materials ranging from Li to Pb. These fluctuations are correlated with a linear dependence of the 'apparent' meanlife tau on the electronic slowing down time

  1. Consistent evaluations of (n,2n) and (n,np) reaction excitation functions for some even-even isotopes using empirical systematics

    Energy Technology Data Exchange (ETDEWEB)

    Manokhin, Vassily N. [Russian Nuclear Data Center, Institute of Physics and Power Engineering, Obninsk (Russian Federation); Odano, Naoteru; Hasegawa, Akira [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    2001-03-01

    An approach for consistent evaluation of (n,2n) and (n,np) reaction excitation functions for some even-even isotopes with the (n,np) reaction thresholds lower than (n,2n) reaction ones is described. For determination of cross sections in the maximum of the (n,2n) and (n,np) reaction excitation functions some empirical systematics developed by Manokhin were used together with trends in dependence of gaps between the (n,2n) and (n,np) thresholds on atomic mass number A. The shapes of the (n,2n) and (n,np) reaction excitation functions were calculated using the normalized functions from the Manokhin's systematics. Excitation functions of (n,2n) and (n,np) reactions were evaluated for several nuclei by using the systematics and it was found that the approach used for the present study gives reasonable results. (author)

  2. Dependability and Survivability Evaluation of a Water Distribution Process with Arcade

    NARCIS (Netherlands)

    Roolvink, S.; Remke, Anne Katharina Ingrid; Stoelinga, Mariëlle Ida Antoinette

    2009-01-01

    Among others, drinking water belongs to the socalled critical infrastructures. To ensure that the water production meets current and future societal needs, a systematic and rigorous analysis is needed. In this paper, we report our ��?rst experience with dependability analysis of the last phase of a

  3. Error evaluation method for material accountancy measurement. Evaluation of random and systematic errors based on material accountancy data

    International Nuclear Information System (INIS)

    Nidaira, Kazuo

    2008-01-01

    International Target Values (ITV) shows random and systematic measurement uncertainty components as a reference for routinely achievable measurement quality in the accountancy measurement. The measurement uncertainty, called error henceforth, needs to be periodically evaluated and checked against ITV for consistency as the error varies according to measurement methods, instruments, operators, certified reference samples, frequency of calibration, and so on. In the paper an error evaluation method was developed with focuses on (1) Specifying clearly error calculation model, (2) Getting always positive random and systematic error variances, (3) Obtaining probability density distribution of an error variance and (4) Confirming the evaluation method by simulation. In addition the method was demonstrated by applying real data. (author)

  4. Evaluation of size dependent design shear strength of reinforced ...

    Indian Academy of Sciences (India)

    to the development of the size dependent models on the shear strength in ... predict the diagonal cracking strength and the ultimate shear strength of RC ... ing strength of normal beams was by Zsutty (1968) based on the data base available without .... The comparison of the calculated shear strength of the beams is shown.

  5. Systematics of alpha Q-values. Potential dependence of the alpha decay life time

    International Nuclear Information System (INIS)

    Sato, Hiroshi

    1994-01-01

    It has been considered that the life time of α decay can be explained by calculating the probability of α getting out through the composite field of nuclear force and Coulomb force, that alpha and remaining nuclei make, by tunnel effect. However, when the detailed theoretical calculation was performed, the large difference from the experimental values was found. The researches which, have been carried out before are introduced. In this report, it is shown that when the treatment of Arima and Yoshida's way is carried out by using the realistic field of nuclear force and Coulomb force, the half life of α decay in considerably wide range can be calculated by considering the results of Tonozuka and Arima. The systematics of α Q-values is explained. The method of determining the life time of α decay is examined. The comparison of the calculated values and the experimental values of the α decay of 20 Ne and 212 Po is shown. This method of calculating the half life of α decay can reproduce the experimental values well. The application is considered to the estimation of the life of unstable nuclei, the new approach to heavy particle decay and others. (K.I.)

  6. Systematic analysis of dependent human errors from the maintenance history at finnish NPPs - A status report

    Energy Technology Data Exchange (ETDEWEB)

    Laakso, K. [VTT Industrial Systems (Finland)

    2002-12-01

    Operating experience has shown missed detection events, where faults have passed inspections and functional tests to operating periods after the maintenance activities during the outage. The causes of these failures have often been complex event sequences, involving human and organisational factors. Especially common cause and other dependent failures of safety systems may significantly contribute to the reactor core damage risk. The topic has been addressed in the Finnish studies of human common cause failures, where experiences on latent human errors have been searched and analysed in detail from the maintenance history. The review of the bulk of the analysis results of the Olkiluoto and Loviisa plant sites shows that the instrumentation and control and electrical equipment is more prone to human error caused failure events than the other maintenance and that plant modifications and also predetermined preventive maintenance are significant sources of common cause failures. Most errors stem from the refuelling and maintenance outage period at the both sites, and less than half of the dependent errors were identified during the same outage. The dependent human errors originating from modifications could be reduced by a more tailored specification and coverage of their start-up testing programs. Improvements could also be achieved by a more case specific planning of the installation inspection and functional testing of complicated maintenance works or work objects of higher plant safety and availability importance. A better use and analysis of condition monitoring information for maintenance steering could also help. The feedback from discussions of the analysis results with plant experts and professionals is still crucial in developing the final conclusions and recommendations that meet the specific development needs at the plants. (au)

  7. Tincture of opium for treating opioid dependence: a systematic review of safety and efficacy.

    Science.gov (United States)

    Nikoo, Mohammadali; Nikoo, Nooshin; Anbardan, Sanam Javid; Amiri, Afshar; Vogel, Marc; Choi, Fiona; Sepehry, Amir Ali; Bagheri Valoojerdi, Amir Hooshang; Jang, Kerry; Schütz, Christian; Akhondzadeh, Shahin; Krausz, Michael

    2017-03-01

    Recently, there has been a growing interest in using opium tincture (OT) for treating opioid dependence in certain regions. We aimed to assess the evidence on its safety and efficacy for this indication. We searched several databases (CENTRAL, Medline, EMBASE, Web of Science, PsychINFO, ProQuest Dissertation and Theses Database, Iran Medex, clinicaltrials.gov and who.int/trialsearch) with no language or publication date limitations. Two reviewers selected randomized controlled trials (RCT), cohort/case-control/cross-sectional studies and case-series on safety or efficacy of OT for treating opioid dependence and then extracted reported measures of mentioned outcomes from selected studies. We used the Effective Public Health Practice Project (EPHPP) Quality Assessment tool for appraisal. From nine selected studies; in three RCTs and one cohort analytical analysis on detoxification, 110 patients were treated with 15-140 morphine equivalents/day (mEq/d) of OT; in four prospective and one retrospective uncontrolled case-series on long-term/maintenance treatment, 570 patients were treated with 100-400 mEq/d of OT. Only two studies on detoxification included a comparison: one concluded equal efficacy of OT and methadone in suppressing withdrawal symptoms (P = 0.32) and the other concluded OT to be less efficacious than buprenorphine/naloxone in suppressing withdrawal [OT = 12.20, 95% confidence interval (CI) = 11.00, 13.40]; control: 5.20 (95% CI = 4.69, 5.71) and craving (OT = 303.0, 95% CI = -144.664, 750.664; control: 0.0) but not significantly different (P = 0.26) in retaining participants in treatment. No major adverse events were reported. Conclusive recommendations about the safety and efficacy of opium tincture for treating opioid dependence are not possible at this time. © 2016 Society for the Study of Addiction.

  8. Evaluation of Role of Myofibroblasts in Oral Cancer: A Systematic Review.

    Science.gov (United States)

    Sekhon, Harjeet K; Sircar, Keya; Kaur, Gurbani; Marwah, Muneet

    2016-01-01

    To conduct a systematic review on the role of myofibroblasts in progression of oral cancer. The myofibroblast is essential for the integrity of the mammalian body by virtue of its role in wound healing, but it also plays a negative role due to their role in promoting tumor development. Systematic review. Bibliographic searches were conducted in several electronic databases using all publications in PubMed, PubMed central, EMBASE, CancerLit, Google scholar, and Cochrane CCTR between 1990 and June 2015. The search of all publications from various electronic databases revealed 1,371 citations. The total number of studies considered for systematic review was 43. The total number of patients included in the studies was 990. Myofibroblasts are a significant component in stroma of oral cancer cases, though not identified in all cases. This systematic review shows that clinical, pathological, and immunohistochemistry tests have correlated the presence of high myofibroblast count in oral cancer cell stroma. Myofibroblasts play a significant role in oral cancer invasion and progression. Various studies have demonstrated their association with oral cancer. This review tends to highlight their role in the pathogenesis of oral cancer over the decade. Sekhon HK, Sircar K, Kaur G, Marwah M. Evaluation of Role of Myofibroblasts in Oral Cancer: A Systematic Review. Int J Clin Pediatr Dent 2016;9(3):233-239.

  9. Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review

    Science.gov (United States)

    Kim, Ha-Young; Shin, Sang-Wan

    2014-01-01

    PURPOSE The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva

  10. Evaluation of design safety factors for time-dependent buckling

    International Nuclear Information System (INIS)

    Stone, C.M.; Nickell, R.E.

    1977-02-01

    The ASME Boiler and Pressure Vessel Code rules concerning time-dependent (creep) buckling for Class 1 nuclear components have recently been changed. Previous requirements for a factor of ten on service life have been replaced with a factor of safety of 1.5 on loading for load-controlled buckling. This report examines the supposed equivalence of the two rules from the standpoint of materials behavior--specifically, the secondary creep strain rate exponent. The comparison is made using results obtained numerically for an axially-loaded, cylindrical shell with varying secondary creep exponents. A computationally efficient scheme for analyzing creep buckling problems is also presented

  11. Ethnic Background and Genetic Variation in the Evaluation of Cancer Risk: A Systematic Review

    Science.gov (United States)

    Jing, Lijun; Su, Li; Ring, Brian Z.

    2014-01-01

    The clinical use of genetic variation in the evaluation of cancer risk is expanding, and thus understanding how determinants of cancer susceptibility identified in one population can be applied to another is of growing importance. However there is considerable debate on the relevance of ethnic background in clinical genetics, reflecting both the significance and complexity of genetic heritage. We address this via a systematic review of reported associations with cancer risk for 82 markers in 68 studies across six different cancer types, comparing association results between ethnic groups and examining linkage disequilibrium between risk alleles and nearby genetic loci. We find that the relevance of ethnic background depends on the question. If asked whether the association of variants with disease risk is conserved across ethnic boundaries, we find that the answer is yes, the majority of markers show insignificant variability in association with cancer risk across ethnic groups. However if the question is whether a significant association between a variant and cancer risk is likely to reproduce, the answer is no, most markers do not validate in an ethnic group other than the discovery cohort’s ancestry. This lack of reproducibility is not attributable to studies being inadequately populated due to low allele frequency in other ethnic groups. Instead, differences in local genomic structure between ethnic groups are associated with the strength of association with cancer risk and therefore confound interpretation of the implied physiologic association tracked by the disease allele. This suggest that a biological association for cancer risk alleles may be broadly consistent across ethnic boundaries, but reproduction of a clinical study in another ethnic group is uncommon, in part due to confounding genomic architecture. As clinical studies are increasingly performed globally this has important implications for how cancer risk stratifiers should be studied and

  12. Ethnic background and genetic variation in the evaluation of cancer risk: a systematic review.

    Science.gov (United States)

    Jing, Lijun; Su, Li; Ring, Brian Z

    2014-01-01

    The clinical use of genetic variation in the evaluation of cancer risk is expanding, and thus understanding how determinants of cancer susceptibility identified in one population can be applied to another is of growing importance. However there is considerable debate on the relevance of ethnic background in clinical genetics, reflecting both the significance and complexity of genetic heritage. We address this via a systematic review of reported associations with cancer risk for 82 markers in 68 studies across six different cancer types, comparing association results between ethnic groups and examining linkage disequilibrium between risk alleles and nearby genetic loci. We find that the relevance of ethnic background depends on the question. If asked whether the association of variants with disease risk is conserved across ethnic boundaries, we find that the answer is yes, the majority of markers show insignificant variability in association with cancer risk across ethnic groups. However if the question is whether a significant association between a variant and cancer risk is likely to reproduce, the answer is no, most markers do not validate in an ethnic group other than the discovery cohort's ancestry. This lack of reproducibility is not attributable to studies being inadequately populated due to low allele frequency in other ethnic groups. Instead, differences in local genomic structure between ethnic groups are associated with the strength of association with cancer risk and therefore confound interpretation of the implied physiologic association tracked by the disease allele. This suggest that a biological association for cancer risk alleles may be broadly consistent across ethnic boundaries, but reproduction of a clinical study in another ethnic group is uncommon, in part due to confounding genomic architecture. As clinical studies are increasingly performed globally this has important implications for how cancer risk stratifiers should be studied and employed.

  13. Ethnic background and genetic variation in the evaluation of cancer risk: a systematic review.

    Directory of Open Access Journals (Sweden)

    Lijun Jing

    Full Text Available The clinical use of genetic variation in the evaluation of cancer risk is expanding, and thus understanding how determinants of cancer susceptibility identified in one population can be applied to another is of growing importance. However there is considerable debate on the relevance of ethnic background in clinical genetics, reflecting both the significance and complexity of genetic heritage. We address this via a systematic review of reported associations with cancer risk for 82 markers in 68 studies across six different cancer types, comparing association results between ethnic groups and examining linkage disequilibrium between risk alleles and nearby genetic loci. We find that the relevance of ethnic background depends on the question. If asked whether the association of variants with disease risk is conserved across ethnic boundaries, we find that the answer is yes, the majority of markers show insignificant variability in association with cancer risk across ethnic groups. However if the question is whether a significant association between a variant and cancer risk is likely to reproduce, the answer is no, most markers do not validate in an ethnic group other than the discovery cohort's ancestry. This lack of reproducibility is not attributable to studies being inadequately populated due to low allele frequency in other ethnic groups. Instead, differences in local genomic structure between ethnic groups are associated with the strength of association with cancer risk and therefore confound interpretation of the implied physiologic association tracked by the disease allele. This suggest that a biological association for cancer risk alleles may be broadly consistent across ethnic boundaries, but reproduction of a clinical study in another ethnic group is uncommon, in part due to confounding genomic architecture. As clinical studies are increasingly performed globally this has important implications for how cancer risk stratifiers should be

  14. Predictors of Shunt-dependent Hydrocephalus After Aneurysmal Subarachnoid Hemorrhage? A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Xie, Zhiyi; Hu, Xin; Zan, Xin; Lin, Sen; Li, Hao; You, Chao

    2017-10-01

    Hydrocephalus is a well-recognized complication after aneurysmal subarachnoid hemorrhage (aSAH). This study aimed to identify predictors for shunt-dependent hydrocephalus (SDHC) after aSAH via a systematic review and meta-analysis. A systematic search was conducted using the Embase, MEDLINE, and Web of Science databases for studies pertaining to aSAH and SDHC. Risk factors were assessed by meta-analysis when they were reported by at least 2 studies. The results were presented as odd ratios or risk ratios according to the study design with the corresponding 95% confidence intervals (CI). Twenty-five studies were included. In primary analysis of 14 potential risk factors, 12 were identified as predictors of SDHC after aSAH including age ≥50 years, female gender, high Hunt-Hess grade, Glasgow Coma Scale ≤8, Fisher grade ≥3, acute hydrocephalus, external ventricular drainage insertion, intraventricular hemorrhage, postcirculation aneurysm, anterior communicating artery aneurysm, meningitis, and rebleeding. The meta-analysis based on cohort studies found a significantly increased risk for SDHC in patients with aSAH treated by coiling (risk ratio, 1.16; 95% CI, 1.05-1.29), while the meta-analysis based on case-controlled studies failed to replicate this finding (odds ratio, 1.27; 95% CI, 0.95-1.71). Several new predictors of SDHC after aSAH were identified that may assist with the early recognition and prevention of SDHC. The controversial evidence found in this study was insufficient to support the potential of neurosurgical clipping for reducing the risk of shunt dependency. Further well-designed studies are warranted to explore the effect of treatment modality on SDHC risk. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Evaluation of patient self-management outcomes in health care: a systematic review.

    Science.gov (United States)

    Du, S; Yuan, C

    2010-06-01

    The importance of self-management and its intervention for improving the ability and skill of self-management has been discussed in literatures. It is, however, unclear how to choose the fitted, objective and accurate evaluation system when assessing the outcome. The aim of this article was to establish a general evaluation system for skill and ability of self-management in chronic diseases through systematic review on different evaluation indicators and scales. A systematic search of six electronic databases was conducted. Two authors independently reviewed each qualified study for relevance and significance. Subsequently, main evaluation indicators and scales were identified and categorized into themes and sub-themes. Nineteen articles were identified in this review. Among them, six main evaluation indicators of self-management, including frequently used scales, were extracted and tabulated. Self-efficacy, health behaviour/attitude, health status, health service utilization, quality of life and psychological indicators were the main indicators in evaluating self-management outcome, and they could be used alone or in combination flexibly according to the different goals of programmes. Accurate evaluation of skill and ability of self-management is crucial not only in baseline data collection but also in proving the effectiveness of intervention. The outcomes of this study provide future researchers or caregivers with a better understanding and a series of good choices in self-management outcome evaluation.

  16. Study on the systematic approach of Markov modeling for dependability analysis of complex fault-tolerant features with voting logics

    International Nuclear Information System (INIS)

    Son, Kwang Seop; Kim, Dong Hoon; Kim, Chang Hwoi; Kang, Hyun Gook

    2016-01-01

    The Markov analysis is a technique for modeling system state transitions and calculating the probability of reaching various system states. While it is a proper tool for modeling complex system designs involving timing, sequencing, repair, redundancy, and fault tolerance, as the complexity or size of the system increases, so does the number of states of interest, leading to difficulty in constructing and solving the Markov model. This paper introduces a systematic approach of Markov modeling to analyze the dependability of a complex fault-tolerant system. This method is based on the decomposition of the system into independent subsystem sets, and the system-level failure rate and the unavailability rate for the decomposed subsystems. A Markov model for the target system is easily constructed using the system-level failure and unavailability rates for the subsystems, which can be treated separately. This approach can decrease the number of states to consider simultaneously in the target system by building Markov models of the independent subsystems stage by stage, and results in an exact solution for the Markov model of the whole target system. To apply this method we construct a Markov model for the reactor protection system found in nuclear power plants, a system configured with four identical channels and various fault-tolerant architectures. The results show that the proposed method in this study treats the complex architecture of the system in an efficient manner using the merits of the Markov model, such as a time dependent analysis and a sequential process analysis. - Highlights: • Systematic approach of Markov modeling for system dependability analysis is proposed based on the independent subsystem set, its failure rate and unavailability rate. • As an application example, we construct the Markov model for the digital reactor protection system configured with four identical and independent channels, and various fault-tolerant architectures. • The

  17. A systematic review and economic evaluation of bisphosphonates for the prevention of fragility fractures.

    Science.gov (United States)

    Davis, Sarah; Martyn-St James, Marrissa; Sanderson, Jean; Stevens, John; Goka, Edward; Rawdin, Andrew; Sadler, Susi; Wong, Ruth; Campbell, Fiona; Stevenson, Matt; Strong, Mark; Selby, Peter; Gittoes, Neil

    2016-10-01

    Fragility fractures are fractures that result from mechanical forces that would not ordinarily result in fracture. To evaluate the clinical effectiveness and safety of bisphosphonates [alendronic acid (Fosamax ® and Fosamax ® Once Weekly, Merck Sharp & Dohme Ltd), risedronic acid (Actonel ® and Actonel Once a Week ® , Warner Chilcott UK Ltd), ibandronic acid (Bonviva ® , Roche Products Ltd) and zoledronic acid (Aclasta ® , Novartis Pharmaceuticals UK Ltd)] for the prevention of fragility fracture and to assess their cost-effectiveness at varying levels of fracture risk. For the clinical effectiveness review, six electronic databases and two trial registries were searched: MEDLINE, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Web of Science and BIOSIS Previews, Clinicaltrials.gov and World Health Organization International Clinical Trials Registry Platform. Searches were limited by date from 2008 until September 2014. A systematic review and network meta-analysis (NMA) of effectiveness studies were conducted. A review of published economic analyses was undertaken and a de novo health economic model was constructed. Discrete event simulation was used to estimate lifetime costs and quality-adjusted life-years (QALYs) for each bisphosphonate treatment strategy and a strategy of no treatment for a simulated cohort of patients with heterogeneous characteristics. The model was populated with effectiveness evidence from the systematic review and NMA. All other parameters were estimated from published sources. A NHS and Personal Social Services perspective was taken, and costs and benefits were discounted at 3.5% per annum. Fracture risk was estimated from patient characteristics using the QFracture ® (QFracture-2012 open source revision 38, Clinrisk Ltd, Leeds, UK) and FRAX ® (web version 3.9, University of Sheffield, Sheffield, UK) tools. The relationship between fracture risk and incremental net benefit (INB) was

  18. Process variables in organizational stress management intervention evaluation research: a systematic review.

    Science.gov (United States)

    Havermans, Bo M; Schlevis, Roosmarijn Mc; Boot, Cécile Rl; Brouwers, Evelien Pm; Anema, Johannes; van der Beek, Allard J

    2016-09-01

    This systematic review aimed to explore which process variables are used in stress management intervention (SMI) evaluation research. A systematic review was conducted using seven electronic databases. Studies were included if they reported on an SMI aimed at primary or secondary stress prevention, were directed at paid employees, and reported process data. Two independent researchers checked all records and selected the articles for inclusion. Nielsen and Randall's model for process evaluation was used to cluster the process variables. The three main clusters were context, intervention, and mental models. In the 44 articles included, 47 process variables were found, clustered into three main categories: context (two variables), intervention (31 variables), and mental models (14 variables). Half of the articles contained no reference to process evaluation literature. The collection of process evaluation data mostly took place after the intervention and at the level of the employee. The findings suggest that there is great heterogeneity in methods and process variables used in process evaluations of SMI. This, together with the lack of use of a standardized framework for evaluation, hinders the advancement of process evaluation theory development.

  19. Systematic evaluation of a 171Yb optical clock by synchronous comparison between two lattice systems.

    Science.gov (United States)

    Gao, Qi; Zhou, Min; Han, Chengyin; Li, Shangyan; Zhang, Shuang; Yao, Yuan; Li, Bo; Qiao, Hao; Ai, Di; Lou, Ge; Zhang, Mengya; Jiang, Yanyi; Bi, Zhiyi; Ma, Longsheng; Xu, Xinye

    2018-05-22

    Optical clocks are the most precise measurement devices. Here we experimentally characterize one such clock based on the 1 S 0 - 3 P 0 transition of neutral 171 Yb atoms confined in an optical lattice. Given that the systematic evaluation using an interleaved stabilization scheme is unable to avoid noise from the clock laser, synchronous comparisons against a second 171 Yb lattice system were implemented to accelerate the evaluation. The fractional instability of one clock falls below 4 × 10 -17 after an averaging over a time of 5,000 seconds. The systematic frequency shifts were corrected with a total uncertainty of 1.7 × 10 -16 . The lattice polarizability shift currently contributes the largest source. This work paves the way to measuring the absolute clock transition frequency relative to the primary Cs standard or against the International System of Units (SI) second.

  20. Developing a dependable approach for evaluating waste treatment data

    International Nuclear Information System (INIS)

    Gering, K.L.

    1997-01-01

    Decision makers involved with hazardous waste treatment issues are faced with the challenge of making objective evaluations concerning treatment formulations. This work utilizes an effectiveness factor (denoted as η) as the basis for waste treatment evaluations, which was recently developed for application to mixed waste treatability studies involving solidification and stabilization at the Idaho National Engineering and Environmental Laboratory. The effectiveness factor incorporates an arbitrary treatment criterion Φ, which in practice could be the Toxicity Characteristic Leaching Procedure, Unconfined Compressive Strength, Leachability Index, or any other criterion used to judge treatment performance. Three values for Φ are utilized when assessing a given treatment formulation: before treatment, after treatment, and a reference value (typically a treatment standard). The expression for η also incorporates the waste loading as the prime experimental parameter, and accounts for the contribution that each hazard has upon the overall treatment performance. Also discussed are general guidelines for numerical boundaries and statistical interpretations of treatment data. Case studies are presented that demonstrate the usefulness of the effectiveness factor and related numerical methods, where the typical hazards encountered are toxic metals within mixed waste

  1. Evaluation models and criteria of the quality of hospital websites: a systematic review study

    OpenAIRE

    Jeddi, Fatemeh Rangraz; Gilasi, Hamidreza; Khademi, Sahar

    2017-01-01

    Introduction Hospital websites are important tools in establishing communication and exchanging information between patients and staff, and thus should enjoy an acceptable level of quality. The aim of this study was to identify proper models and criteria to evaluate the quality of hospital websites. Methods This research was a systematic review study. The international databases such as Science Direct, Google Scholar, PubMed, Proquest, Ovid, Elsevier, Springer, and EBSCO together with regiona...

  2. CT evaluation of soft tissue and muscle infection and inflammation: A systematic compartmental approach

    Energy Technology Data Exchange (ETDEWEB)

    Beauchamp, N.J. Jr. [Dept. of Radiology, and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Scott, W.W. Jr. [Dept. of Radiology, and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Gottlieb, L.M. [Dept. of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Fishman, E.K. [Dept. of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD (United States)

    1995-07-01

    This essay presents a systematic approach to the evaluation of soft tissue and muscle infection by defining the various pathologic processes and then illustrating them through a series of CT studies with corresponding schematic diagrams. The specific processes discussed are cellulitis, lymphangitis/lymphedema, necrotizing fascitis, myositis/myonecrosis, and abscess. Key points in the differential diagnosis of these entities are discussed and illustrated. The clinical management of the specific pathologic processes is also discussed. (orig./MG)

  3. Ethnic Background and Genetic Variation in the Evaluation of Cancer Risk: A Systematic Review

    OpenAIRE

    Jing, Lijun; Su, Li; Ring, Brian Z.

    2014-01-01

    The clinical use of genetic variation in the evaluation of cancer risk is expanding, and thus understanding how determinants of cancer susceptibility identified in one population can be applied to another is of growing importance. However there is considerable debate on the relevance of ethnic background in clinical genetics, reflecting both the significance and complexity of genetic heritage. We address this via a systematic review of reported associations with cancer risk for 82 markers in ...

  4. A systematic review of factors influencing student ratings in undergraduate medical education course evaluations

    OpenAIRE

    Schiekirka, Sarah; Raupach, Tobias

    2015-01-01

    Background Student ratings are a popular source of course evaluations in undergraduate medical education. Data on the reliability and validity of such ratings have mostly been derived from studies unrelated to medical education. Since medical education differs considerably from other higher education settings, an analysis of factors influencing overall student ratings with a specific focus on medical education was needed. Methods For the purpose of this systematic review, online databases (Pu...

  5. CT evaluation of soft tissue and muscle infection and inflammation: A systematic compartmental approach

    International Nuclear Information System (INIS)

    Beauchamp, N.J. Jr.; Scott, W.W. Jr.; Gottlieb, L.M.; Fishman, E.K.

    1995-01-01

    This essay presents a systematic approach to the evaluation of soft tissue and muscle infection by defining the various pathologic processes and then illustrating them through a series of CT studies with corresponding schematic diagrams. The specific processes discussed are cellulitis, lymphangitis/lymphedema, necrotizing fascitis, myositis/myonecrosis, and abscess. Key points in the differential diagnosis of these entities are discussed and illustrated. The clinical management of the specific pathologic processes is also discussed. (orig./MG)

  6. Evaluation of distance-dependent resolution compensation in brain SPECT

    International Nuclear Information System (INIS)

    Badger, D.P.; Barnden, L.R.

    2010-01-01

    Full text: Conventional SPECT reconstruction assumes that the volume of response for each collimator hole is a cylinder, but due to the finite depth of the holes, the volume of response is actually cone shaped. This leads to a loss of resolution as the distance from the collimator face is increased. If distance-dependent resolution compensation (DRC) is incorporated into an iterative reconstruction algorithm, then some of the lost resolution can be recovered (T Yokoi, H Shinohara and H Onishi. 2002, Ann Nuc Med, 16, 11-18). ORC has recently been included in some commercial reconstruction software, and the aim of this study was to assess whether the significantly increased reconstruction processing time can be justified for clinical or for research purposes. HMPAO brain scans from 104 healthy subjects were reconstructed using iterative OSEM, with and without ORC. A voxel based iterative sensitivity (VBIS) technique was used for gain correction in the scans. A Statistical Parametric Mapping (SPM) analysis found the statistical strength of the SPECT aging effect increased when the non-DRC image set was compared to the images with ORC, probably due to improvement in the imaging of partial volume effects when the interhemispheric fissure and sulci enlarge with age (L Barnden, S Behin Ain, R Kwiatek, R Casse and L Yelland. 2005, Nuc Med Comm, 26, 497-503). It was concluded that the use of ORC is justified for research purposes, but may not be for routine clinical use. (author)

  7. Process evaluations in neurological rehabilitation: a mixed-evidence systematic review and recommendations for future research.

    Science.gov (United States)

    Masterson-Algar, Patricia; Burton, Christopher R; Rycroft-Malone, Jo

    2016-11-08

    To systematically review how process evaluations are currently designed, what methodologies are used and how are they developed alongside or within neurological rehabilitation trials. This mixed-methods systematic review had two evidence streams: stream I, studies reporting process evaluations alongside neurorehabilitation trials research and stream II, methodological guidance on process evaluation design and methodology. A search strategy was designed for each evidence stream. Data regarding process evaluation core concepts and design issues were extracted using a bespoke template. Evidence from both streams was analysed separately and then synthesised in a final overarching synthesis proposing a number of recommendations for future research. A total of 124 process evaluation studies, reporting on 106 interventions, were included in stream I evidence. 30 studies were included as stream II evidence. Synthesis 1 produced 9 themes, and synthesis 2 identified a total of 8 recommendations for process evaluation research. The overall synthesis resulted in 57 'synthesis recommendations' about process evaluation methodology grouped into 9 research areas, including the use of theory, the investigation of context, intervention staff characteristics and the delivery of the trial intervention. There remains no consensus regarding process evaluation terminology within the neurological rehabilitation field. There is a need for process evaluations to address the nature and influence of context over time. Process evaluations should clearly describe what intervention staff bring to a trial, including skills and experience prior to joining the research. Process evaluations should monitor intervention staff's learning effects and the possible impact that these may have on trial outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Quality Assessment of Studies Published in Open Access and Subscription Journals: Results of a Systematic Evaluation.

    Science.gov (United States)

    Pastorino, Roberta; Milovanovic, Sonja; Stojanovic, Jovana; Efremov, Ljupcho; Amore, Rosarita; Boccia, Stefania

    2016-01-01

    Along with the proliferation of Open Access (OA) publishing, the interest for comparing the scientific quality of studies published in OA journals versus subscription journals has also increased. With our study we aimed to compare the methodological quality and the quality of reporting of primary epidemiological studies and systematic reviews and meta-analyses published in OA and non-OA journals. In order to identify the studies to appraise, we listed all OA and non-OA journals which published in 2013 at least one primary epidemiologic study (case-control or cohort study design), and at least one systematic review or meta-analysis in the field of oncology. For the appraisal, we picked up the first studies published in 2013 with case-control or cohort study design from OA journals (Group A; n = 12), and in the same time period from non-OA journals (Group B; n = 26); the first systematic reviews and meta-analyses published in 2013 from OA journals (Group C; n = 15), and in the same time period from non-OA journals (Group D; n = 32). We evaluated the methodological quality of studies by assessing the compliance of case-control and cohort studies to Newcastle and Ottawa Scale (NOS) scale, and the compliance of systematic reviews and meta-analyses to Assessment of Multiple Systematic Reviews (AMSTAR) scale. The quality of reporting was assessed considering the adherence of case-control and cohort studies to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist, and the adherence of systematic reviews and meta-analyses to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. Among case-control and cohort studies published in OA and non-OA journals, we did not observe significant differences in the median value of NOS score (Group A: 7 (IQR 7-8) versus Group B: 8 (7-9); p = 0.5) and in the adherence to STROBE checklist (Group A, 75% versus Group B, 80%; p = 0.1). The results did not change after adjustment

  9. Systematic studies of charge-dependent azimuthal correlation in pPb and PbPb collisions at the LHC

    CERN Document Server

    Tu, Zhoudunming

    2017-01-01

    Studies of charge-dependent azimuthal correlations for same- and opposite-sign particle pairs are presented in PbPb collisions at 5.02 TeV and pPb collisions at 5.02 and 8.16 TeV, with the CMS experiment at the LHC. The azimuthal correlations are evaluated with respect to the second- and also higher-order event planes, as a function of particle pseudorapidity and transverse momentum, and event multiplicity. By employing an event-shape engineering technique, the dependence of correlations on azimuthal anisotropy flow is investigated. Results presented provide new insights to the origin of observed charge-dependent azimuthal correlations, and have important implications to the search for the chiral magnetic effect in heavy ion collisions.

  10. Electronic and optical properties of families of polycyclic aromatic hydrocarbons: A systematic (time-dependent) density functional theory study

    International Nuclear Information System (INIS)

    Malloci, G.; Cappellini, G.; Mulas, G.; Mattoni, A.

    2011-01-01

    Graphical abstract: Electronic absorption spectra of the neutral molecules of the four PAH classes considered, as computed using the real-time real-space TD-DFT. Highlights: →We present a systematic comparative study of families of PAHs. → We computed electronic, optical, and transport properties as a function of size. → We considered oligoacenes, phenacenes, circumacenes, and oligorylenes. → Circumacenes have the best transport properties compared to the other classes. → Oligorylenes are much more efficient in absorbing low-energy photons. - Abstract: Homologous classes of polycyclic aromatic hydrocarbons (PAHs) in their crystalline state are among the most promising materials for organic opto-electronics. Following previous works on oligoacenes we present a systematic comparative study of the electronic, optical, and transport properties of oligoacenes, phenacenes, circumacenes, and oligorylenes. Using density functional theory (DFT) and time-dependent DFT we computed: (i) electron affinities and first ionization energies; (ii) quasiparticle correction to the highest occupied molecular orbital (HOMO)-lowest unoccupied molecular orbital (LUMO) gap; (iii) molecular reorganization energies and (iv) electronic absorption spectra of neutral and ±1 charged systems. The excitonic effects are estimated by comparing the optical gap and the quasiparticle corrected HOMO-LUMO energy gap. For each molecular property computed, general trends as a function of molecular size and charge state are discussed. Overall, we find that circumacenes have the best transport properties, displaying a steeper decrease of the molecular reorganization energy at increasing sizes, while oligorylenes are much more efficient in absorbing low-energy photons in comparison to the other classes.

  11. Volume and health outcomes: evidence from systematic reviews and from evaluation of Italian hospital data.

    Science.gov (United States)

    Amato, Laura; Fusco, Danilo; Acampora, Anna; Bontempi, Katia; Rosa, Alessandro Cesare; Colais, Paola; Cruciani, Fabio; D'Ovidio, Mariangela; Mataloni, Francesca; Minozzi, Silvia; Mitrova, Zuzana; Pinnarelli, Luigi; Saulle, Rosella; Soldati, Salvatore; Sorge, Chiara; Vecchi, Simona; Ventura, Martina; Davoli, Marina

    2017-01-01

    BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions. OBJECTIVES To identify conditions/interventions for which an association between volume and outcome has been investigated. To identify conditions/interventions for which an association between volume and outcome has been proved. To analyze the distribution of Italian health providers by volume of activity. To measure the association between volume of care and outcomes of the health providers of the Italian National Health Service (NHS). METHODS Systematic review An overview of systematic reviews was performed searching PubMed, EMBASE, and The Cochrane Library up to November 2016. Studies were evaluated by 2 researchers independently; quality assessment was performed using the AMSTAR checklist. For each health condition and outcome, if available, total number of studies, participants, high volume cut-off values, and metanalysis have been reported. According to the considered outcomes, health topics were classified into 3 groups: positive association: a positive association was demonstrated in the majority of studies/participants and/or a pooled measure (metanalysis) with positive results was reported; lack of association: both studies and/or metanalysis showed no association; no sufficient evidence of association: both results of single studies and metanalysis do not allow to draw firm conclusions

  12. Seismic hazard review for the systematic evaluation program: a use of probability in decision making

    International Nuclear Information System (INIS)

    Reiter, L.; Jackson, R.E.

    1983-03-01

    This document presents the US Nuclear Regulatory Commission (NRC) Geosciences Branch review and recommendations with respect to earthquake ground motion considerations in the Systematic Evaluation Program (SEP) Phases I and II. It evaluates the probabilistic estimates presented in the 5-volume report entitled Seismic Hazard Analysis (NUREG/CR-1582) and compares and modifies them to take into account deterministic estimates. It presents the NRC's Geosciences Branch first approach to utilizing complex state-of-the-art probabilistic studies in an area where probabilistic criteria have not yet been set and where decisions for specific plants have been previously made in a non-probabilistic way

  13. Automatic Evaluations and Exercising: Systematic Review and Implications for Future Research.

    Science.gov (United States)

    Schinkoeth, Michaela; Antoniewicz, Franziska

    2017-01-01

    The general purpose of this systematic review was to summarize, structure and evaluate the findings on automatic evaluations of exercising. Studies were eligible for inclusion if they reported measuring automatic evaluations of exercising with an implicit measure and assessed some kind of exercise variable. Fourteen nonexperimental and six experimental studies (out of a total N = 1,928) were identified and rated by two independent reviewers. The main study characteristics were extracted and the grade of evidence for each study evaluated. First, results revealed a large heterogeneity in the applied measures to assess automatic evaluations of exercising and the exercise variables. Generally, small to large-sized significant relations between automatic evaluations of exercising and exercise variables were identified in the vast majority of studies. The review offers a systematization of the various examined exercise variables and prompts to differentiate more carefully between actually observed exercise behavior (proximal exercise indicator) and associated physiological or psychological variables (distal exercise indicator). Second, a lack of transparent reported reflections on the differing theoretical basis leading to the use of specific implicit measures was observed. Implicit measures should be applied purposefully, taking into consideration the individual advantages or disadvantages of the measures. Third, 12 studies were rated as providing first-grade evidence (lowest grade of evidence), five represent second-grade and three were rated as third-grade evidence. There is a dramatic lack of experimental studies, which are essential for illustrating the cause-effect relation between automatic evaluations of exercising and exercise and investigating under which conditions automatic evaluations of exercising influence behavior. Conclusions about the necessity of exercise interventions targeted at the alteration of automatic evaluations of exercising should therefore

  14. Consumer evaluation of food with nutritional benefits: a systematic review and narrative synthesis.

    Science.gov (United States)

    Mogendi, Joseph Birundu; De Steur, Hans; Gellynck, Xavier; Makokha, Anselimo

    2016-06-01

    As a consequence of the growing interest in, and development of, various types of food with nutritional benefits, the modern consumer views their kitchen cabinet more and more as a medicine cabinet. Given that consumer evaluation of food is considered key to the successful production, marketing and finally consumption of food, a procedure commonly used in medical fields was employed to systematically review and summarize evidence of consumer evaluation studies on nutritious foods. The focus is primarily on consumer understanding of nutritious food and the underlying determinants of consumer evaluation. Our results highlight four groups of key determinants: (1) nutrition knowledge and information; (2) attitudes, beliefs, perceptions and behavioural determinants; (3) price, process and product characteristics; and (4) socio-demographics. The findings also point to the importance of understanding consumer acceptance as one many concepts in the consumer evaluation process, and provide support for developing appropriate strategies for improving health and well-being of consumers.

  15. Integrated Plant Safety Assessment, Systematic Evaluation Program: Yankee Nuclear Power Station (Docket No. 50-29)

    International Nuclear Information System (INIS)

    1987-10-01

    The US Nuclear Regulatory Commission (NRC) has prepared Supplement 1 to the final Integrated Plant Safety Assessment Report (IPSAR) (NUREG-0825), under the scope of the Systematic Evaluation Program (SEP), for Yankee Atomic Electric Company's Yankee Nuclear Power Station located in Rowe, Massachusetts. The SEP was initiated by the NRC to review the design of older operating nuclear power plants to reconfirm and document their safety. This report documents the review completed under the SEP for those issues that required refined engineering evaluations or the continuation of ongoing evaluations after the Final IPSAR for the Yankee plant was issued. The review has provided for (1) an assessment of the significance of differences between current technical positions on selected safety issues and those that existed when Yankee was licensed, (2) a basis for deciding how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. 2 tabs

  16. A systematic review of studies evaluating diffusion and dissemination of selected cancer control interventions.

    Science.gov (United States)

    Ellis, Peter; Robinson, Paula; Ciliska, Donna; Armour, Tanya; Brouwers, Melissa; O'Brien, Mary Ann; Sussman, Jonathan; Raina, Parminder

    2005-09-01

    With this review, the authors sought to determine what strategies have been evaluated (including the outcomes assessed) to disseminate cancer control interventions that promote the uptake of behavior change. Five topic areas along the cancer care continuum (smoking cessation, healthy diet, mammography, cervical cancer screening, and control of cancer pain) were selected to be representative. A systematic review was conducted of primary studies evaluating dissemination of a cancer control intervention. Thirty-one studies were identified that evaluated dissemination strategies in the 5 topic areas. No strong evidence currently exists to recommend any one dissemination strategy as effective in promoting the uptake of cancer control interventions. The authors conclude that there is a strong need for more research into dissemination of cancer control interventions. Future research should consider methodological issues such as the most appropriate study design and outcomes to be evaluated. (c) 2005 APA, all rights reserved

  17. The Systematic Approach to Training: Analysis and Evaluation in the Department of Safeguards

    International Nuclear Information System (INIS)

    Ticevic, S.; Weichselbraun, A.; Pickett, S.; Crete, J.-M.

    2015-01-01

    In applying a systematic approach to training (SAT), identifying the learning needs is the first step - a learning needs analysis allows the organization to identify the competencies required to perform a particular job. A systematic approach can provide a clear structure for training and education programme development as well as the necessary evaluation and feedback so that the organization can adjust the development accordingly and deliver the optimal learning experience. In this presentation we will describes two key elements of a SAT used in the Safeguards Training Section in the Department of Safeguards: Analysis and Evaluation. Analysis is the first part of a SAT needed to define competencies for Safeguards staff in order to improve training development within the Department. We describe the training needs analysis used to capture and articulate the various competencies required for safeguards implementation based upon an analysis of tasks and activities carried out by staff members in the Department. Firstly, we highlight the different qualitative methods used to gather information from staff and the process of evaluating and organizing this information into a structured framework. Secondly, we describe how this framework provides the necessary reference to specify learning objectives, evaluate training effectiveness, review and revise training offerings, and select appropriate training paths based on identified needs. In addition, as part of the SAT, evaluation is performed to identify the usefulness of course outcomes and improvements for future offerings based on lessons learned, to ensure that appropriate knowledge and skills are being taught and to demonstrate the value of training by meeting the organization's needs. We present how the Kirkpatrick four-level evaluation model has been implemented by Safeguards Training Section in order to evaluate course effectiveness after the training has been completed, and discuss how the current evaluation

  18. Evaluation Studies of Robotic Rollators by the User Perspective: A Systematic Review.

    Science.gov (United States)

    Werner, Christian; Ullrich, Phoebe; Geravand, Milad; Peer, Angelika; Hauer, Klaus

    2016-01-01

    Robotic rollators enhance the basic functions of established devices by technically advanced physical, cognitive, or sensory support to increase autonomy in persons with severe impairment. In the evaluation of such ambient assisted living solutions, both the technical and user perspectives are important to prove usability, effectiveness and safety, and to ensure adequate device application. The aim of this systematic review is to summarize the methodology of studies evaluating robotic rollators with focus on the user perspective and to give recommendations for future evaluation studies. A systematic literature search up to December 31, 2014, was conducted based on the Cochrane Review methodology using the electronic databases PubMed and IEEE Xplore. Articles were selected according to the following inclusion criteria: evaluation studies of robotic rollators documenting human-robot interaction, no case reports, published in English language. Twenty-eight studies were identified that met the predefined inclusion criteria. Large heterogeneity in the definitions of the target user group, study populations, study designs and assessment methods was found across the included studies. No generic methodology to evaluate robotic rollators could be identified. We found major methodological shortcomings related to insufficient sample descriptions and sample sizes, and lack of appropriate, standardized and validated assessment methods. Long-term use in habitual environment was also not evaluated. Apart from the heterogeneity, methodological deficits in most of the identified studies became apparent. Recommendations for future evaluation studies include: clear definition of target user group, adequate selection of subjects, inclusion of other assistive mobility devices for comparison, evaluation of the habitual use of advanced prototypes, adequate assessment strategy with established, standardized and validated methods, and statistical analysis of study results. Assessment

  19. Photogrammetry as a tool for the postural evaluation of the spine: A systematic review.

    Science.gov (United States)

    Furlanetto, Tássia Silveira; Sedrez, Juliana Adami; Candotti, Cláudia Tarragô; Loss, Jefferson Fagundes

    2016-02-18

    To evaluate the use of photogrammetry and identify the mathematical procedures applied when evaluating spinal posture. A systematic search using keywords was conducted in the PubMed, EMBASE, Scopus, Science and Medicine(®) databases. The following inclusion criteria adopted were: (1) the use of photogrammetry as a method to evaluate spinal posture; (2) evaluations of spinal curvature in the sagittal and/or frontal plane; (3) studies published within the last three decades; and (4) written entirely in English. The exclusion criteria were: (1) studies which objective involved the verification of some aspect of validation of instruments; (2) studies published as abstracts and those published in scientific events; and (3) studies using evaluation of the anteriorization of the head to determine the angular positioning of the cervical spine. The articles in this review were included and evaluated for their methodological quality, based on the Downs and Black scale, by two independent reviewers. Initially, 1758 articles were found, 76 of which were included upon reading the full texts and 29 were included in accordance with the predetermined criteria. In addition, after analyzing the references in those articles, a further six articles were selected, so that 35 articles were included in this review. This systematic review revealed that the photogrammetry has been using in observational studies. Furthermore, it was also found that, although the data collection methodologies are similar across the studies, in relation to aspects of data analysis, the methodologies are very different, especially regarding the mathematical routines employed to support different postural evaluation software. With photogrammetry, the aim of the assessment, whether it is for clinical, research or collective health purposes, must be considered when choosing which protocol to use to evaluate spinal posture.

  20. Systematic evaluation of non-animal test methods for skin sensitisation safety assessment.

    Science.gov (United States)

    Reisinger, Kerstin; Hoffmann, Sebastian; Alépée, Nathalie; Ashikaga, Takao; Barroso, Joao; Elcombe, Cliff; Gellatly, Nicola; Galbiati, Valentina; Gibbs, Susan; Groux, Hervé; Hibatallah, Jalila; Keller, Donald; Kern, Petra; Klaric, Martina; Kolle, Susanne; Kuehnl, Jochen; Lambrechts, Nathalie; Lindstedt, Malin; Millet, Marion; Martinozzi-Teissier, Silvia; Natsch, Andreas; Petersohn, Dirk; Pike, Ian; Sakaguchi, Hitoshi; Schepky, Andreas; Tailhardat, Magalie; Templier, Marie; van Vliet, Erwin; Maxwell, Gavin

    2015-02-01

    The need for non-animal data to assess skin sensitisation properties of substances, especially cosmetics ingredients, has spawned the development of many in vitro methods. As it is widely believed that no single method can provide a solution, the Cosmetics Europe Skin Tolerance Task Force has defined a three-phase framework for the development of a non-animal testing strategy for skin sensitization potency prediction. The results of the first phase – systematic evaluation of 16 test methods – are presented here. This evaluation involved generation of data on a common set of ten substances in all methods and systematic collation of information including the level of standardisation, existing test data,potential for throughput, transferability and accessibility in cooperation with the test method developers.A workshop was held with the test method developers to review the outcome of this evaluation and to discuss the results. The evaluation informed the prioritisation of test methods for the next phase of the non-animal testing strategy development framework. Ultimately, the testing strategy – combined with bioavailability and skin metabolism data and exposure consideration – is envisaged to allow establishment of a data integration approach for skin sensitisation safety assessment of cosmetic ingredients.

  1. Systematic Review of Health Economic Evaluation Studies Developed in Brazil from 1980 to 2013.

    Science.gov (United States)

    Decimoni, Tassia Cristina; Leandro, Roseli; Rozman, Luciana Martins; Craig, Dawn; Iglesias, Cynthia P; Novaes, Hillegonda Maria Dutilh; de Soárez, Patrícia Coelho

    2018-01-01

    Brazil has sought to use economic evaluation to support healthcare decision-making processes. While a number of health economic evaluations (HEEs) have been conducted, no study has systematically reviewed the quality of Brazilian HEE. The objective of this systematic review was to provide an overview regarding the state of HEE research and to evaluate the number, characteristics, and quality of reporting of published HEE studies conducted in a Brazilian setting. We systematically searched electronic databases (MEDLINE, EMBASE, Latin American, and Caribbean Literature on Health Sciences Database, Scientific Electronic Library Online, NHS Economic Evaluation Database, health technology assessment Database, Bireme, and Biblioteca Virtual em Saúde Economia da Saúde ); citation indexes (SCOPUS, Web of Science), and Sistema de Informação da Rede Brasileira de Avaliação de Tecnologia em Saúde . Partial and full HEEs published between 1980 and 2013 that referred to a Brazilian setting were considered for inclusion. In total, 535 studies were included in the review, 36.8% of these were considered to be full HEE. The category of healthcare technologies more frequently assessed were procedures (34.8%) and drugs (28.8%) which main objective was treatment (72.1%). Forty-four percent of the studies reported their funding source and 36% reported a conflict of interest. Overall, the full HEE quality of reporting was satisfactory. But some items were generally poorly reported and significant improvement is required: (1) methods used to estimate healthcare resource use quantities and unit costs, (2) methods used to estimate utility values, (3) sources of funding, and (4) conflicts of interest. A steady number of HEE have been published in Brazil since 1980. To improve their contribution to inform national healthcare policy efforts need to be made to enhance the quality of reporting of HEEs and promote improvements in the way HEEs are designed, implemented (i.e., using sound

  2. Using resource dependency theory to measure the environment in health care organizational studies: a systematic review of the literature.

    Science.gov (United States)

    Yeager, Valerie A; Menachemi, Nir; Savage, Grant T; Ginter, Peter M; Sen, Bisakha P; Beitsch, Leslie M

    2014-01-01

    Studies using the resource dependency theory (RDT) perspective commonly focus on one or more of the following environmental dimensions: munificence, dynamism, and complexity. To date, no one has reviewed the use of this theory in the health care management literature and there exists no consensus on how to operationalize the market environment in health care settings. The purpose of this review is to examine and summarize the ways in which RDT has been applied in empirical studies of the external environments of health care organizations. In so doing, we identify gaps in the literature and examine the extent to which previous empirical findings aligned with hypothesized relationships based on RDT. We conducted a systematic review of the peer-reviewed literature using a bibliographic search of PubMed and ABI/Inform databases. To identify all health care studies that incorporated the RDT perspective, the words "healthcare" or "health care" were searched in combination with any of the following words: resource dependency theory, uncertainty perspective, environment, munificence, dynamism, and complexity. We also performed a hand search of the reference lists of all manuscripts identified in the initial search to identify additional articles. Twenty studies were included in this review. Wide variability existed in the number of variables used to measure the environment, the environmental constructs measured, and the specific variables used to operationalizethe environmental constructs. Of the 198 tests examining the relationship between environmental variables and the outcome of interest, 26.8% resulted in findings that supported the RDT-predicted hypotheses. The RDT literature is limited to studies of hospitals, nursing homes, and medical practices. There is little consensus on how to measure or operationalize the environment in these studies. No previous studies have measured the environment for other health care settings such as ambulatory surgery centers, public

  3. Systematic spatial bias in DNA microarray hybridization is caused by probe spot position-dependent variability in lateral diffusion.

    Science.gov (United States)

    Steger, Doris; Berry, David; Haider, Susanne; Horn, Matthias; Wagner, Michael; Stocker, Roman; Loy, Alexander

    2011-01-01

    The hybridization of nucleic acid targets with surface-immobilized probes is a widely used assay for the parallel detection of multiple targets in medical and biological research. Despite its widespread application, DNA microarray technology still suffers from several biases and lack of reproducibility, stemming in part from an incomplete understanding of the processes governing surface hybridization. In particular, non-random spatial variations within individual microarray hybridizations are often observed, but the mechanisms underpinning this positional bias remain incompletely explained. This study identifies and rationalizes a systematic spatial bias in the intensity of surface hybridization, characterized by markedly increased signal intensity of spots located at the boundaries of the spotted areas of the microarray slide. Combining observations from a simplified single-probe block array format with predictions from a mathematical model, the mechanism responsible for this bias is found to be a position-dependent variation in lateral diffusion of target molecules. Numerical simulations reveal a strong influence of microarray well geometry on the spatial bias. Reciprocal adjustment of the size of the microarray hybridization chamber to the area of surface-bound probes is a simple and effective measure to minimize or eliminate the diffusion-based bias, resulting in increased uniformity and accuracy of quantitative DNA microarray hybridization.

  4. Calcium/Calmodulin-dependent Protein Kinase II is a Ubiquitous Molecule in Human Long-term Memory Synaptic Plasticity: A Systematic Review

    Science.gov (United States)

    Ataei, Negar; Sabzghabaee, Ali Mohammad; Movahedian, Ahmad

    2015-01-01

    Background: Long-term memory is based on synaptic plasticity, a series of biochemical mechanisms include changes in structure and proteins of brain's neurons. In this article, we systematically reviewed the studies that indicate calcium/calmodulin kinase II (CaMKII) is a ubiquitous molecule among different enzymes involved in human long-term memory and the main downstream signaling pathway of long-term memory. Methods: All of the observational, case–control and review studies were considered and evaluated by the search engines PubMed, Cochrane Central Register of Controlled Trials and ScienceDirect Scopus between 1990 and February 2015. We did not carry out meta-analysis. Results: At the first search, it was fined 1015 articles which included “synaptic plasticity” OR “neuronal plasticity” OR “synaptic density” AND memory AND “molecular mechanism” AND “calcium/calmodulin-dependent protein kinase II” OR CaMKII as the keywords. A total of 335 articles were duplicates in the databases and eliminated. A total of 680 title articles were evaluated. Finally, 40 articles were selected as reference. Conclusions: The studies have shown the most important intracellular signal of long-term memory is calcium-dependent signals. Calcium linked calmodulin can activate CaMKII. After receiving information for learning and memory, CaMKII is activated by Glutamate, the most important neurotransmitter for memory-related plasticity. Glutamate activates CaMKII and it plays some important roles in synaptic plasticity modification and long-term memory. PMID:26445635

  5. A protocol for a systematic review of the use of process evaluations in knowledge translation research.

    Science.gov (United States)

    Scott, Shannon D; Rotter, Thomas; Hartling, Lisa; Chambers, Thane; Bannar-Martin, Katherine H

    2014-12-23

    through complementary process evaluations alongside trials. This systematic review will serve as a 'state of the science' on methodological approaches to process evaluations and will allow us to: 1) take stock of current research approaches and 2) develop concrete recommendations for knowledge users (e.g., quality consultants and health services researchers) designing future KT process evaluations.

  6. Systematic Evaluation of Methods for Integration of Transcriptomic Data into Constraint-Based Models of Metabolism

    DEFF Research Database (Denmark)

    Machado, Daniel; Herrgard, Markus

    2014-01-01

    of these methods has not been critically evaluated and compared. This work presents a survey of recently published methods that use transcript levels to try to improve metabolic flux predictions either by generating flux distributions or by creating context-specific models. A subset of these methods...... is then systematically evaluated using published data from three different case studies in E. coli and S. cerevisiae. The flux predictions made by different methods using transcriptomic data are compared against experimentally determined extracellular and intracellular fluxes (from 13C-labeling data). The sensitivity...... of the results to method-specific parameters is also evaluated, as well as their robustness to noise in the data. The results show that none of the methods outperforms the others for all cases. Also, it is observed that for many conditions, the predictions obtained by simple flux balance analysis using growth...

  7. Evaluation of photonuclear reaction cross-sections using the reduction method for large systematic uncertainties

    International Nuclear Information System (INIS)

    Varlamov, V.V.; Efimkin, N.G.; Ishkhanov, B.S.; Sapunenko, V.V.

    1994-12-01

    The authors describe a method based on the reduction method for the evaluation of photonuclear reaction cross-sections obtained under conditions where there are large systematic uncertainties (different instrumental functions, calibration and normalization errors). The evaluation method involves using the actual instrumental function (photon spectrum) of each individual experiment to reduce the data to a representation generated by an instrumental function of better quality. The objective is to find the most reasonably achievable monoenergetic representation of the information on the reaction cross-section derived from the results of various experiments and to take into account the calibration and normalization errors in these experiments. The method was used to obtain the evaluated total photoneutron reaction cross-section (γ,xn) for a large number of nuclei. Data obtained for 16 O and 208 Pb are presented. (author). 36 refs, 6 figs, 4 tabs

  8. A systematic review of health economic evaluations of vaccines in Brazil.

    Science.gov (United States)

    Sartori, Ana Marli Christovam; Rozman, Luciana Martins; Decimoni, Tassia Cristina; Leandro, Roseli; Novaes, Hillegonda Maria Dutilh; de Soárez, Patrícia Coelho

    2017-06-03

    In Brazil, since 2005, the Ministry of Health requires Health Economic Evaluation (HEE) of vaccines for introduction into the National Immunization Program. To describe and analyze the full HEE on vaccines conducted in Brazil from 1980 to 2013. Systematic review of the literature. We searched multiple databases. Two researchers independently selected the studies and extracted the data. The methodological quality of individual studies was evaluated using CHEERS items. Twenty studies were reviewed. The most evaluated vaccines were pneumococcal (25%) and HPV (15%). The most used types of HEE were cost-effectiveness analysis (45%) and cost-utility analysis (20%). The research question and compared strategies were stated in all 20 studies and the target population was clear in 95%. Nevertheless, many studies did not inform the perspective of analysis or data sources. HEE of vaccines in Brazil has increased since 2008. However, the studies still have methodological deficiencies.

  9. Drug repurposing: a systematic approach to evaluate candidate oral neuroprotective interventions for secondary progressive multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Hanna M Vesterinen

    Full Text Available To develop and implement an evidence based framework to select, from drugs already licenced, candidate oral neuroprotective drugs to be tested in secondary progressive multiple sclerosis.Systematic review of clinical studies of oral putative neuroprotective therapies in MS and four other neurodegenerative diseases with shared pathological features, followed by systematic review and meta-analyses of the in vivo experimental data for those interventions. We presented summary data to an international multi-disciplinary committee, which assessed each drug in turn using pre-specified criteria including consideration of mechanism of action.We identified a short list of fifty-two candidate interventions. After review of all clinical and pre-clinical evidence we identified ibudilast, riluzole, amiloride, pirfenidone, fluoxetine, oxcarbazepine, and the polyunsaturated fatty-acid class (Linoleic Acid, Lipoic acid; Omega-3 fatty acid, Max EPA oil as lead candidates for clinical evaluation.We demonstrate a standardised and systematic approach to candidate identification for drug rescue and repurposing trials that can be applied widely to neurodegenerative disorders.

  10. The design, implementation, and evaluation of online credit nutrition courses: a systematic review.

    Science.gov (United States)

    Cohen, Nancy L; Carbone, Elena T; Beffa-Negrini, Patricia A

    2011-01-01

    To assess how postsecondary online nutrition education courses (ONEC) are delivered, determine ONEC effectiveness, identify theoretical models used, and identify future research needs. Systematic search of database literature. Postsecondary education. Nine research articles evaluating postsecondary ONEC. Knowledge/performance outcomes and student satisfaction, motivation, or perceptions. Systematic search of 922 articles and review of 9 articles meeting search criteria. Little research regarding ONEC marketing/management existed. Studies primarily evaluated introductory courses using email/websites (before 2000), or course management systems (after 2002). None used true experimental designs; just 3 addressed validity or reliability of measures or pilot-tested instruments. Three articles used theoretical models in course design; few used theories to guide evaluations. Four quasi-experimental studies indicated no differences in nutrition knowledge/performance between online and face-to-face learners. Results were inconclusive regarding student satisfaction, motivation, or perceptions. Students can gain knowledge in online as well as in face-to-face nutrition courses, but satisfaction was mixed. More up-to-date investigations on effective practices are warranted, using theories to identify factors that enhance student outcomes, addressing emerging technologies, and documenting ONEC marketing, management, and delivery. Adequate training/support for faculty is needed to improve student experiences and faculty time management. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  11. A systematic meta-review of evaluations of youth violence prevention programs: Common and divergent findings from 25 years of meta-analyses and systematic reviews☆

    Science.gov (United States)

    Matjasko, Jennifer L.; Vivolo-Kantor, Alana M.; Massetti, Greta M.; Holland, Kristin M.; Holt, Melissa K.; Cruz, Jason Dela

    2018-01-01

    Violence among youth is a pervasive public health problem. In order to make progress in reducing the burden of injury and mortality that result from youth violence, it is imperative to identify evidence-based programs and strategies that have a significant impact on violence. There have been many rigorous evaluations of youth violence prevention programs. However, the literature is large, and it is difficult to draw conclusions about what works across evaluations from different disciplines, contexts, and types of programs. The current study reviews the meta-analyses and systematic reviews published prior to 2009 that synthesize evaluations of youth violence prevention programs. This meta-review reports the findings from 37 meta-analyses and 15 systematic reviews; the included reviews were coded on measures of the social ecology, prevention approach, program type, and study design. A majority of the meta-analyses and systematic reviews were found to demonstrate moderate program effects. Meta-analyses yielded marginally smaller effect sizes compared to systematic reviews, and those that included programs targeting family factors showed marginally larger effects than those that did not. In addition, there are a wide range of individual/family, program, and study moderators of program effect sizes. Implications of these findings and suggestions for future research are discussed. PMID:29503594

  12. Systematic evaluation of drug-disease relationships to identify leads for novel drug uses.

    Science.gov (United States)

    Chiang, A P; Butte, A J

    2009-11-01

    Drug repositioning refers to the discovery of alternative uses for drugs--uses that are different from that for which the drugs were originally intended. One challenge in this effort lies in choosing the indication for which a drug of interest could be prospectively tested. We systematically evaluated a drug treatment-based view of diseases in order to address this challenge. Suggestions for novel drug uses were generated using a "guilt by association" approach. When compared with a control group of drug uses, the suggested novel drug uses generated by this approach were significantly enriched with respect to previous and ongoing clinical trials.

  13. Early economic evaluation of emerging health technologies: protocol of a systematic review

    Science.gov (United States)

    2014-01-01

    Background The concept of early health technology assessment, discussed well over a decade, has now been collaboratively implemented by industry, government, and academia to select and expedite the development of emerging technologies that may address the needs of patients and health systems. Early economic evaluation is essential to assess the value of emerging technologies, but empirical data to inform the current practice of early evaluation is limited. We propose a systematic review of early economic evaluation studies in order to better understand the current practice. Methods/design This protocol describes a systematic review of economic evaluation studies of regulated health technologies in which the evaluation is conducted prior to regulatory approval and when the technology effectiveness is not well established. Included studies must report an economic evaluation, defined as the comparative analysis of alternatives with respect to their associated costs and health consequences, and must evaluate some regulated health technology such as pharmaceuticals, biologics, high-risk medical devices, or biomarkers. We will conduct the literature search on multiple databases, including MEDLINE, EMBASE, the Centre for Reviews and Dissemination Databases, and EconLit. Additional citations will be identified via scanning reference lists and author searching. We suspect that many early economic evaluation studies are unpublished, especially those conducted for internal use only. Additionally, we use a chain-referral sampling approach to identify authors of unpublished studies who work in technology discovery and development, starting out with our contact lists and authors who published relevant studies. Citation screening and full-text review will be conducted by pairs of reviewers. Abstracted data will include those related to the decision context and decision problem of the early evaluation, evaluation methods (e.g., data sources, methods, and assumptions used to

  14. Do Student Evaluations of Teaching Depend on the Distribution of Expected Grade?

    Science.gov (United States)

    Matos-Diaz, Horacio; Ragan, James F., Jr.

    2010-01-01

    Prior research suggests that student evaluations of teaching may depend on the average grade expected in a class. We hypothesize that, because of risk aversion, student ratings also depend on the distribution of expected grades. As predicted, student ratings at the University of Puerto Rico at Bayamon are significantly and negatively related to…

  15. A systematic review of economic evaluations of health and health-related interventions in Bangladesh

    Directory of Open Access Journals (Sweden)

    Koehlmoos Tracey P

    2011-07-01

    Full Text Available Abstract Background Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Methods Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Result Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER. Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Conclusion Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis

  16. A systematic review of economic evaluations of health and health-related interventions in Bangladesh

    Science.gov (United States)

    2011-01-01

    Background Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Methods Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Result Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER). Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Conclusion Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis of knowledge in the area. The

  17. [Creation of a scale for evaluating attitudes of partners toward alcohol dependency].

    Science.gov (United States)

    Sugawara, Tazuko; Morita, Noriaki; Nakatani, Youji

    2013-12-01

    The aim of this study was to develop a scale to evaluate characteristics of how alcohol-dependent people perceive the attitudes of their partners toward alcohol dependency. Based on previous research, we created the "Attitudes of partners toward alcohol dependency" scale, from the perspective of the alcohol dependent individual. Using the new scale, 71 alcohol-dependent people (52 men, 19 women) were surveyed after obtaining their consent, and the reliability and validity of the scale were tested. The results identified 3 factors, "indifference", "acceptance" and "hypersensitivity", and factorial validity was verified. Relatively high reliability was obtained on each sub-scale (alpha = .60-.82). Furthermore, correlations were obtained with the alcohol-dependency "Denial and Awareness Scale (for alcohol-dependent people)" and with the 13-item "Usefulness of heterosexual love relations for recovery from alcohol dependency" questionnaire, which includes content on "beneficial" or "obstructive" to recovery, and with the satisfaction and the importance of relations. This demonstrates that the "Attitudes of partners toward alcohol dependency" scale has reliability and criterion-related validity. The scale facilitates evaluation of types of attitudes of partners toward alcohol dependency, and may thus be useful as one tool for investigating the influence of partners in heterosexual love relationships for recovery, and for providing advice.

  18. A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support.

    Science.gov (United States)

    Greenwood, Deborah A; Gee, Perry M; Fatkin, Kathy J; Peeples, Malinda

    2017-09-01

    Since the introduction of mobile phones, technology has been increasingly used to enable diabetes self-management education and support. This timely systematic review summarizes how currently available technology impacts outcomes for people living with diabetes. A systematic review of high quality review articles and meta analyses focused on utilizing technology in diabetes self-management education and support services was conducted. Articles were included if published between January 2013 and January 2017. Twenty-five studies were included for analysis. The majority evaluated the use of mobile phones and secure messaging. Most studies described healthy eating, being active and metabolic monitoring as the predominant self-care behaviors evaluated. Eighteen of 25 reviews reported significant reduction in A1c as an outcome measure. Four key elements emerged as essential for improved A1c: (1) communication, (2) patient-generated health data, (3) education, and (4) feedback. Technology-enabled diabetes self-management solutions significantly improve A1c. The most effective interventions incorporated all the components of a technology-enabled self-management feedback loop that connected people with diabetes and their health care team using 2-way communication, analyzed patient-generated health data, tailored education, and individualized feedback. The evidence from this systematic review indicates that organizations, policy makers and payers should consider integrating these solutions in the design of diabetes self-management education and support services for population health and value-based care models. With the widespread adoption of mobile phones, digital health solutions that incorporate evidence-based, behaviorally designed interventions can improve the reach and access to diabetes self-management education and ongoing support.

  19. SPECTRAL PROPERTIES OF LARGE GRADUAL SOLAR ENERGETIC PARTICLE EVENTS. II. SYSTEMATIC Q/M DEPENDENCE OF HEAVY ION SPECTRAL BREAKS

    Energy Technology Data Exchange (ETDEWEB)

    Desai, M. I.; Dayeh, M. A.; Ebert, R. W.; Schwadron, N. A. [Southwest Research Institute, 6220 Culebra Road, San Antonio, TX 78238 (United States); Mason, G. M. [Johns Hopkins University/Applied Physics Laboratory, Laurel, MD 20723 (United States); McComas, D. J. [Department of Astrophysical Sciences, Princeton University, NJ 08544 (United States); Li, G. [The Center for Space Plasma and Aeronomic Research (CSPAR), University of Alabama in Huntsville, Huntsville, AL 35756 (United States); Cohen, C. M. S.; Mewaldt, R. A. [California Institute of Technology, Pasadena, CA 91125 (United States); Smith, C. W., E-mail: mdesai@swri.edu [University of New Hampshire, 8 College Road, Durham NH 03824 (United States)

    2016-09-10

    We fit ∼0.1–500 MeV nucleon{sup −1} H–Fe spectra in 46 large solar energetic particle (SEP) events with the double power-law Band function to obtain a normalization constant, low- and high-energy parameters γ {sub a} and γ {sub b}, and break energy E {sub B}, and derive the low-energy spectral slope γ {sub 1}. We find that: (1) γ {sub a}, γ {sub 1}, and γ {sub b} are species-independent and the spectra steepen with increasing energy; (2) E {sub B} decreases systematically with decreasing Q/M scaling as (Q/M){sup α}; (3) α varies between ∼0.2–3 and is well correlated with the ∼0.16–0.23 MeV nucleon{sup −1} Fe/O; (4) in most events, α < 1.4, γ {sub b}– γ {sub a} > 3, and O E {sub B} increases with γ {sub b}– γ {sub a}; and (5) in many extreme events (associated with faster coronal mass ejections (CMEs) and GLEs), Fe/O and {sup 3}He/{sup 4}He ratios are enriched, α ≥ 1.4, γ {sub b}– γ {sub a} < 3, and E {sub B} decreases with γ {sub b}– γ {sub a}. The species-independence of γ {sub a}, γ {sub 1}, and γ {sub b} and the Q/M dependence of E {sub B} within an event and the α values suggest that double power-law SEP spectra occur due to diffusive acceleration by near-Sun CME shocks rather than scattering in interplanetary turbulence. Using γ {sub 1}, we infer that the average compression ratio for 33 near-Sun CME shocks is 2.49 ± 0.08. In most events, the Q/M dependence of E {sub B} is consistent with the equal diffusion coefficient condition and the variability in α is driven by differences in the near-shock wave intensity spectra, which are flatter than the Kolmogorov turbulence spectrum but weaker than the spectra for extreme events. In contrast, in extreme events, enhanced wave power enables faster CME shocks to accelerate impulsive suprathermal ions more efficiently than ambient coronal ions.

  20. Economic evaluation of pediatric influenza immunization program compared with other pediatric immunization programs: A systematic review.

    Science.gov (United States)

    Gibson, Edward; Begum, Najida; Sigmundsson, Birgir; Sackeyfio, Alfred; Hackett, Judith; Rajaram, Sankarasubramanian

    2016-05-03

    This study compared the economic value of pediatric immunisation programmes for influenza to those for rotavirus (RV), meningococcal disease (MD), pneumococcal disease (PD), human papillomavirus (HPV), hepatitis B (Hep B), and varicella reported in recent (2000 onwards) cost-effectiveness (CE) studies identified in a systematic review of PubMed, health technology, and vaccination databases. The systematic review yielded 51 economic evaluation studies of pediatric immunisation - 10 (20%) for influenza and 41 (80%) for the other selected diseases. The quality of the eligible articles was assessed using Drummond's checklist. Although inherent challenges and limitations exist when comparing economic evaluations of immunisation programmes, an overall comparison of the included studies demonstrated cost-effectiveness/cost saving for influenza from a European-Union-Five (EU5) and United States (US) perspective; point estimates for cost/quality-adjusted life-years (QALY) from dominance (cost-saving with more effect) to ≤45,444 were reported. The economic value of influenza programmes was comparable to the other vaccines of interest, with cost/QALY in general considerably lower than RV, Hep B, MD and PD. Independent of the perspective and type of analysis, the economic impact of a pediatric influenza immunisation program was influenced by vaccine efficacy, immunisation coverage, costs, and most significantly by herd immunity. This review suggests that pediatric influenza immunisation may offer a cost effective strategy when compared with HPV and varicella and possibly more value compared with other childhood vaccines (RV, Hep B, MD and PD).

  1. [Systematic evaluation of retention behavior of carbohydrates in hydrophilic interaction liquid chromatography].

    Science.gov (United States)

    Fu, Qing; Wang, Jun; Liang, Tu; Xu, Xiaoyong; Jin, Yu

    2013-11-01

    A systematic evaluation of retention behavior of carbohydrates in hydrophilic interaction liquid chromatography (HILIC) was performed. The influences of mobile phase, stationary phase and buffer salt on the retention of carbohydrates were investigated. According to the results, the retention time of carbohydrates decreased as the proportion of acetonitrile in mobile phase decreased. Increased time of carbohydrates was observed as the concentration of buffer salt in mobile phase increased. The retention behavior of carbohydrates was also affected by organic solvent and HILIC stationary phase. Furthermore, an appropriate retention equation was used in HILIC mode. The retention equation lnk = a + blnC(B) + cC(B) could quantitatively describe the retention factors of carbohydrates of plant origin with good accuracy: the relative error of the predicted time to actual time was less than 0.3%. The evaluation results could provide guidance for carbohydrates to optimize the experimental conditions in HILIC method development especially for carbohydrate separation

  2. Measurement properties of exsisting clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, B; Lund, H

    (COSMIN checklist), the methodological quality in the reliability and validity domains was ‘fair’ (57%) to ‘poor’ (43%), with only one study rated as ‘good’. The reliability domain was most often investigated. Fewof the assessment methods in the included studies that had ‘fair’ or ‘good’ measurement......MEASUREMENT PROPERTIES OF EXISTING CLINICAL ASSESSMENT METHODS EVALUATING SCAPULAR POSITIONING AND FUNCTION. A SYSTEMATIC REVIEW1,2Camilla Marie Larsen, 1,3Birgit Juul-Kristensen, 1,3Hans Lund, 1Karen Søgaard1Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark2......,2]. Rehabilitation exercises are aiming at altering abnormal/asymmetric scapular positioning and/or function. Numerous assessment methods have measured the degree of scapular dyskinesis, subjectively by visual evaluation and objectively by measurements of static and dynamic scapular positioning, by either a 3...

  3. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans

    %), with only one study rated as ‘good’. The reliability domain was most often investigated. Fewof the assessment methods in the included studies that had ‘fair’ or ‘good’ measurement properties demonstrated acceptable results for both reliability and validity.ConclusionWe found a substantially larger number......ABSTRACT OARSI Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review Larsen CM1, Juul-Kristensen B1,2 Lund H1,2, Søgaard K11University of Southern Denmark, Institute of Sports Science and Clinical Biomechanics2Institute...... assessment methods have measured the degree of scapular dyskinesis, subjectively by visual evaluation and objectively by measurements of static and dynamic scapular positioning, by either a 3-dimensional electromagnetic device or 2-dimensional clinically applicable methods. Since advanced equipment (i.e. 3D...

  4. Road safety effects of porous asphalt: a systematic review of evaluation studies

    DEFF Research Database (Denmark)

    Elvik, R.; Greibe, Poul

    2005-01-01

    of eighteen estimates of the effect of porous asphalt on accident rates. No clear effect on road safety of porous asphalt was found. All summary estimates of effect indicated very small changes in accident rates and very few were statistically significant at conventional levels. Studies that have evaluated...... of these changes in risk factors on accident occurrence cannot be predicted. On the whole, the research that has been reported so far regarding road safety effects of porous asphalt is inconclusive. The studies are not of high quality and the findings are inconsistent.......This paper presents a systematic review of studies that have evaluated the effects on road safety of porous asphalt. Porous asphalt is widely used on motorways in Europe, mainly in order to reduce traffic noise and increase road capacity. A meta-analysis was made of six studies, containing a total...

  5. Qualitative Evaluation Methods in Ethics Education: A Systematic Review and Analysis of Best Practices.

    Science.gov (United States)

    Watts, Logan L; Todd, E Michelle; Mulhearn, Tyler J; Medeiros, Kelsey E; Mumford, Michael D; Connelly, Shane

    2017-01-01

    Although qualitative research offers some unique advantages over quantitative research, qualitative methods are rarely employed in the evaluation of ethics education programs and are often criticized for a lack of rigor. This systematic review investigated the use of qualitative methods in studies of ethics education. Following a review of the literature in which 24 studies were identified, each study was coded based on 16 best practices characteristics in qualitative research. General thematic analysis and grounded theory were found to be the dominant approaches used. Researchers are effectively executing a number of best practices, such as using direct data sources, structured data collection instruments, non-leading questioning, and expert raters. However, other best practices were rarely present in the courses reviewed, such as collecting data using multiple sources, methods, raters, and timepoints, evaluating reliability, and employing triangulation analyses to assess convergence. Recommendations are presented for improving future qualitative research studies in ethics education.

  6. Evaluating clinical ethics support in mental healthcare: a systematic literature review.

    Science.gov (United States)

    Hem, Marit Helene; Pedersen, Reidar; Norvoll, Reidun; Molewijk, Bert

    2015-06-01

    A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five studies were included. The ethics support activities described were moral case deliberations and ethics rounds. Different qualitative and quantitative research methods were utilized. The results show that (a) participants felt that they gained an increased insight into moral issues through systematic reflection; (b) there was improved cooperation among multidisciplinary team members; (c) it was uncertain whether clinical ethics support services led to better patient care; (d) the issue of patient and client participation is complex; and (e) the implementation process is challenging. Clinical ethics support services have mainly been studied through the experiences of the participating facilitators and healthcare professionals. Hence, there is limited knowledge of whether and how various types of clinical ethics support services influence the quality of care and how patients and relatives may evaluate clinical ethics support services. Based on the six excluded 'grey zone articles', in which there was an implicit focus on ethics reflection, other ways of working with ethical reflection in practice are discussed. Implementing and evaluating clinical ethics support services as approaches to clinical ethics support that are more integrated into the development of good practice are in focus. In order to meet some of the shortcomings of the field of clinical ethics support services, a research project that aims to strengthen ethics support in the mental health services, including patients' and caregivers' views on ethical challenges, is presented. © The Author(s) 2014.

  7. A systematic review evaluating the psychometric properties of measures of social inclusion

    Science.gov (United States)

    Milbourn, Ben; Martin, Robyn; Buchanan, Angus; Chung, Donna; Speyer, Renée

    2017-01-01

    Introduction Improving social inclusion opportunities for population health has been identified as a priority area for international policy. There is a need to comprehensively examine and evaluate the quality of psychometric properties of measures of social inclusion that are used to guide social policy and outcomes. Objective To conduct a systematic review of the literature on all current measures of social inclusion for any population group, to evaluate the quality of the psychometric properties of identified measures, and to evaluate if they capture the construct of social inclusion. Methods A systematic search was performed using five electronic databases: CINAHL, PsycINFO, Embase, ERIC and Pubmed and grey literature were sourced to identify measures of social inclusion. The psychometric properties of the social inclusion measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Results Of the 109 measures identified, twenty-five measures, involving twenty-five studies and one manual met the inclusion criteria. The overall quality of the reviewed measures was variable, with the Social and Community Opportunities Profile-Short, Social Connectedness Scale and the Social Inclusion Scale demonstrating the strongest evidence for sound psychometric quality. The most common domain included in the measures was connectedness (21), followed by participation (19); the domain of citizenship was covered by the least number of measures (10). No single instrument measured all aspects within the three domains of social inclusion. Of the measures with sound psychometric evidence, the Social and Community Opportunities Profile-Short captured the construct of social inclusion best. Conclusions The overall quality of the psychometric properties demonstrate that the current suite of available instruments for the measurement of social inclusion are promising but need further refinement. There is a need for a universal working

  8. A systematic review evaluating the psychometric properties of measures of social inclusion.

    Science.gov (United States)

    Cordier, Reinie; Milbourn, Ben; Martin, Robyn; Buchanan, Angus; Chung, Donna; Speyer, Renée

    2017-01-01

    Improving social inclusion opportunities for population health has been identified as a priority area for international policy. There is a need to comprehensively examine and evaluate the quality of psychometric properties of measures of social inclusion that are used to guide social policy and outcomes. To conduct a systematic review of the literature on all current measures of social inclusion for any population group, to evaluate the quality of the psychometric properties of identified measures, and to evaluate if they capture the construct of social inclusion. A systematic search was performed using five electronic databases: CINAHL, PsycINFO, Embase, ERIC and Pubmed and grey literature were sourced to identify measures of social inclusion. The psychometric properties of the social inclusion measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Of the 109 measures identified, twenty-five measures, involving twenty-five studies and one manual met the inclusion criteria. The overall quality of the reviewed measures was variable, with the Social and Community Opportunities Profile-Short, Social Connectedness Scale and the Social Inclusion Scale demonstrating the strongest evidence for sound psychometric quality. The most common domain included in the measures was connectedness (21), followed by participation (19); the domain of citizenship was covered by the least number of measures (10). No single instrument measured all aspects within the three domains of social inclusion. Of the measures with sound psychometric evidence, the Social and Community Opportunities Profile-Short captured the construct of social inclusion best. The overall quality of the psychometric properties demonstrate that the current suite of available instruments for the measurement of social inclusion are promising but need further refinement. There is a need for a universal working definition of social inclusion as an overarching

  9. A systematic and critical review of model-based economic evaluations of pharmacotherapeutics in patients with bipolar disorder.

    Science.gov (United States)

    Mohiuddin, Syed

    2014-08-01

    Bipolar disorder (BD) is a chronic and relapsing mental illness with a considerable health-related and economic burden. The primary goal of pharmacotherapeutics for BD is to improve patients' well-being. The use of decision-analytic models is key in assessing the added value of the pharmacotherapeutics aimed at treating the illness, but concerns have been expressed about the appropriateness of different modelling techniques and about the transparency in the reporting of economic evaluations. This paper aimed to identify and critically appraise published model-based economic evaluations of pharmacotherapeutics in BD patients. A systematic review combining common terms for BD and economic evaluation was conducted in MEDLINE, EMBASE, PSYCINFO and ECONLIT. Studies identified were summarised and critically appraised in terms of the use of modelling technique, model structure and data sources. Considering the prognosis and management of BD, the possible benefits and limitations of each modelling technique are discussed. Fourteen studies were identified using model-based economic evaluations of pharmacotherapeutics in BD patients. Of these 14 studies, nine used Markov, three used discrete-event simulation (DES) and two used decision-tree models. Most of the studies (n = 11) did not include the rationale for the choice of modelling technique undertaken. Half of the studies did not include the risk of mortality. Surprisingly, no study considered the risk of having a mixed bipolar episode. This review identified various modelling issues that could potentially reduce the comparability of one pharmacotherapeutic intervention with another. Better use and reporting of the modelling techniques in the future studies are essential. DES modelling appears to be a flexible and comprehensive technique for evaluating the comparability of BD treatment options because of its greater flexibility of depicting the disease progression over time. However, depending on the research question

  10. Systematic Review of Health Economic Evaluation Studies Developed in Brazil from 1980 to 2013

    Directory of Open Access Journals (Sweden)

    Tassia Cristina Decimoni

    2018-02-01

    Full Text Available BackgroundBrazil has sought to use economic evaluation to support healthcare decision-making processes. While a number of health economic evaluations (HEEs have been conducted, no study has systematically reviewed the quality of Brazilian HEE. The objective of this systematic review was to provide an overview regarding the state of HEE research and to evaluate the number, characteristics, and quality of reporting of published HEE studies conducted in a Brazilian setting.MethodsWe systematically searched electronic databases (MEDLINE, EMBASE, Latin American, and Caribbean Literature on Health Sciences Database, Scientific Electronic Library Online, NHS Economic Evaluation Database, health technology assessment Database, Bireme, and Biblioteca Virtual em Saúde Economia da Saúde; citation indexes (SCOPUS, Web of Science, and Sistema de Informação da Rede Brasileira de Avaliação de Tecnologia em Saúde. Partial and full HEEs published between 1980 and 2013 that referred to a Brazilian setting were considered for inclusion.ResultsIn total, 535 studies were included in the review, 36.8% of these were considered to be full HEE. The category of healthcare technologies more frequently assessed were procedures (34.8% and drugs (28.8% which main objective was treatment (72.1%. Forty-four percent of the studies reported their funding source and 36% reported a conflict of interest. Overall, the full HEE quality of reporting was satisfactory. But some items were generally poorly reported and significant improvement is required: (1 methods used to estimate healthcare resource use quantities and unit costs, (2 methods used to estimate utility values, (3 sources of funding, and (4 conflicts of interest.ConclusionA steady number of HEE have been published in Brazil since 1980. To improve their contribution to inform national healthcare policy efforts need to be made to enhance the quality of reporting of HEEs and promote improvements in the way HEEs are

  11. Does the GPM mission improve the systematic error component in satellite rainfall estimates over TRMM? An evaluation at a pan-India scale

    Science.gov (United States)

    Beria, Harsh; Nanda, Trushnamayee; Singh Bisht, Deepak; Chatterjee, Chandranath

    2017-12-01

    The last couple of decades have seen the outburst of a number of satellite-based precipitation products with Tropical Rainfall Measuring Mission (TRMM) as the most widely used for hydrologic applications. Transition of TRMM into the Global Precipitation Measurement (GPM) promises enhanced spatio-temporal resolution along with upgrades to sensors and rainfall estimation techniques. The dependence of systematic error components in rainfall estimates of the Integrated Multi-satellitE Retrievals for GPM (IMERG), and their variation with climatology and topography, was evaluated over 86 basins in India for year 2014 and compared with the corresponding (2014) and retrospective (1998-2013) TRMM estimates. IMERG outperformed TRMM for all rainfall intensities across a majority of Indian basins, with significant improvement in low rainfall estimates showing smaller negative biases in 75 out of 86 basins. Low rainfall estimates in TRMM showed a systematic dependence on basin climatology, with significant overprediction in semi-arid basins, which gradually improved in the higher rainfall basins. Medium and high rainfall estimates of TRMM exhibited a strong dependence on basin topography, with declining skill in higher elevation basins. The systematic dependence of error components on basin climatology and topography was reduced in IMERG, especially in terms of topography. Rainfall-runoff modeling using the Variable Infiltration Capacity (VIC) model over two flood-prone basins (Mahanadi and Wainganga) revealed that improvement in rainfall estimates in IMERG did not translate into improvement in runoff simulations. More studies are required over basins in different hydroclimatic zones to evaluate the hydrologic significance of IMERG.

  12. Does the GPM mission improve the systematic error component in satellite rainfall estimates over TRMM? An evaluation at a pan-India scale

    Directory of Open Access Journals (Sweden)

    H. Beria

    2017-12-01

    Full Text Available The last couple of decades have seen the outburst of a number of satellite-based precipitation products with Tropical Rainfall Measuring Mission (TRMM as the most widely used for hydrologic applications. Transition of TRMM into the Global Precipitation Measurement (GPM promises enhanced spatio-temporal resolution along with upgrades to sensors and rainfall estimation techniques. The dependence of systematic error components in rainfall estimates of the Integrated Multi-satellitE Retrievals for GPM (IMERG, and their variation with climatology and topography, was evaluated over 86 basins in India for year 2014 and compared with the corresponding (2014 and retrospective (1998–2013 TRMM estimates. IMERG outperformed TRMM for all rainfall intensities across a majority of Indian basins, with significant improvement in low rainfall estimates showing smaller negative biases in 75 out of 86 basins. Low rainfall estimates in TRMM showed a systematic dependence on basin climatology, with significant overprediction in semi-arid basins, which gradually improved in the higher rainfall basins. Medium and high rainfall estimates of TRMM exhibited a strong dependence on basin topography, with declining skill in higher elevation basins. The systematic dependence of error components on basin climatology and topography was reduced in IMERG, especially in terms of topography. Rainfall-runoff modeling using the Variable Infiltration Capacity (VIC model over two flood-prone basins (Mahanadi and Wainganga revealed that improvement in rainfall estimates in IMERG did not translate into improvement in runoff simulations. More studies are required over basins in different hydroclimatic zones to evaluate the hydrologic significance of IMERG.

  13. Isokinetic Evaluation of the Hip Flexor and Extensor Muscles: A Systematic Review.

    Science.gov (United States)

    Zapparoli, Fabricio Yuri; Riberto, Marcelo

    2017-11-01

    Isokinetic dynamometry testing is a safe and reliable method accepted as the "gold standard" in the evaluation of muscle strength in the open kinetic chain. Isokinetic hip examinations face problems in the standardization of the position of the equipment axis, in the individual being examined, and in the adjustment of the lever arm and in stabilization strategies for the patients during the tests. Identification of the methodologic procedures with best reproducibility is also needed. To review the literature to evaluate the parameters used for the isokinetic evaluation of the hip flexor and extensor muscles and its reproducibility. This is a systematic literature review of the Cochrane, LILACS, PEDro, PubMed, and SciELO databases. The inclusion criteria were articles on the evaluation of hip flexor and/or extensor muscular strength with an isokinetic dynamometer and articles that analyzed the ICC or Pearson's reproducibility. The information extracted was positioning of the patient; positioning of the dynamometer axis; positioning of the lever arm; angular speed; sample size, pathology; type of contraction; and ICC and Pearson's results. 204 articles were found, from which 14 were selected that evaluated hip flexor and extensor muscles, involving 550 individuals who were submitted to an isokinetic hip evaluation. Five articles obtained the best result in reproducibility and had their methodology analyzed. To obtain better reproducibility of the isokinetic evaluation of the hip flexor and extensor muscles, the following recommendations must be followed: the individual must be positioned in the supine position and the dynamometer axis must be aligned with the greater trochanter of the femur. The positioning of the lever arm must be in the most distal region of the thigh possible. The angular speed used to analyze torque peak and muscle work was 60°/s, and to evaluate the muscle power it was 180°/s, with concentric and eccentric contractions being analyzed.

  14. Usability Evaluation Methods for Gesture-Based Games: A Systematic Review.

    Science.gov (United States)

    Simor, Fernando Winckler; Brum, Manoela Rogofski; Schmidt, Jaison Dairon Ebertz; Rieder, Rafael; De Marchi, Ana Carolina Bertoletti

    2016-10-04

    Gestural interaction systems are increasingly being used, mainly in games, expanding the idea of entertainment and providing experiences with the purpose of promoting better physical and/or mental health. Therefore, it is necessary to establish mechanisms for evaluating the usability of these interfaces, which make gestures the basis of interaction, to achieve a balance between functionality and ease of use. This study aims to present the results of a systematic review focused on usability evaluation methods for gesture-based games, considering devices with motion-sensing capability. We considered the usability methods used, the common interface issues, and the strategies adopted to build good gesture-based games. The research was centered on four electronic databases: IEEE, Association for Computing Machinery (ACM), Springer, and Science Direct from September 4 to 21, 2015. Within 1427 studies evaluated, 10 matched the eligibility criteria. As a requirement, we considered studies about gesture-based games, Kinect and/or Wii as devices, and the use of a usability method to evaluate the user interface. In the 10 studies found, there was no standardization in the methods because they considered diverse analysis variables. Heterogeneously, authors used different instruments to evaluate gesture-based interfaces and no default approach was proposed. Questionnaires were the most used instruments (70%, 7/10), followed by interviews (30%, 3/10), and observation and video recording (20%, 2/10). Moreover, 60% (6/10) of the studies used gesture-based serious games to evaluate the performance of elderly participants in rehabilitation tasks. This highlights the need for creating an evaluation protocol for older adults to provide a user-friendly interface according to the user's age and limitations. Through this study, we conclude this field is in need of a usability evaluation method for serious games, especially games for older adults, and that the definition of a methodology

  15. Economic evaluation and cost of interventions for cerebral palsy: a systematic review.

    Science.gov (United States)

    Shih, Sophy T F; Tonmukayakul, Utsana; Imms, Christine; Reddihough, Dinah; Graham, H Kerr; Cox, Liz; Carter, Rob

    2018-06-01

    Economic appraisal can help guide policy-making for purchasing decisions, and treatment and management algorithms for health interventions. We conducted a systematic review of economic studies in cerebral palsy (CP) to inform future research. Economic studies published since 1970 were identified from seven databases. Two reviewers independently screened abstracts and extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Any discrepancies were resolved by discussion. Of 980 identified references, 115 were included for full-text assessment. Thirteen articles met standard criteria for a full economic evaluation, two as partial economic evaluations, and 18 as cost studies. Six were full economic evaluations alongside clinical studies or randomized controlled trials, whereas seven involved modelling simulations. The economic case for administration of magnesium sulfate for imminent preterm birth is compelling, achieving both health gain and cost savings. Current literature suggests intrathecal baclofen therapy and botulinum toxin injection are cost-effective, but stronger evidence for long-term effects is needed. Lifestyle and web-based interventions are inexpensive, but broader measurement of outcomes is required. Prevention of CP would avoid significant economic burden. Some treatments and interventions have been shown to be cost-effective, although stronger evidence of clinical effectiveness is needed. What this paper adds Cost-effectiveness evidence shows prevention is the most significant strategy. Some treatments are cost-effective, but stronger evidence for long-term effectiveness is required. Comparison of treatment costs is challenging owing to variations in methodologies and varying clinical indications. © 2018 Mac Keith Press.

  16. A systematic review and overview of health economic evaluations of emergency laparotomy

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    Sohail Bampoe

    2017-11-01

    Full Text Available Abstract Background Little is known about the economic impact of emergency laparotomy (EL surgery in healthcare systems around the world. The aim of this systematic review is to describe the primary resource utilisation, healthcare economic and societal costs of EL in adults in different countries. Methods MEDLINE, EMBASE, ISI Web of Knowledge, Cochrane Central Register Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were searched for full and partial economic analyses of EL published between 1 January 1991 and 31 December 2015. Quality of studies was assessed using the Consensus on Health Economic Criteria (CHEC checklist. Results Sixteen studies were included from a range of countries. One study was a full economic analysis. Fifteen studies were partial economic evaluations. These studies revealed that emergency abdominal surgery is expensive compared to similar elective surgery when comparing primary resource utilisation costs, with an important societal impact. Most contemporaneous studies indicate that in-hospital costs for EL are in excess of US$10,000 per patient episode, rising substantially when societal costs are considered. Discussion EL is a high-risk and costly procedure with a disproportionate financial burden for healthcare providers, relative to national funding provisions and wider societal cost impact. There is substantial heterogeneity in the methodologies and quality of published economic evaluations of EL; therefore, the true economic costs of EL are yet to be fully defined. Future research should focus on developing strategies to embed health economic evaluations within national programmes aiming to improve EL care, including developing the required measures and infrastructure. Conclusions Emergency laparotomy is expensive, with a significant cost burden to healthcare and systems and society worldwide. Novel strategies for reducing this econmic burden should urgently be explored if greater access to

  17. A systematic review and overview of health economic evaluations of emergency laparotomy.

    Science.gov (United States)

    Bampoe, Sohail; Odor, Peter M; Ramani Moonesinghe, S; Dickinson, Matthew

    2017-01-01

    Little is known about the economic impact of emergency laparotomy (EL) surgery in healthcare systems around the world. The aim of this systematic review is to describe the primary resource utilisation, healthcare economic and societal costs of EL in adults in different countries. MEDLINE, EMBASE, ISI Web of Knowledge, Cochrane Central Register Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were searched for full and partial economic analyses of EL published between 1 January 1991 and 31 December 2015. Quality of studies was assessed using the Consensus on Health Economic Criteria (CHEC) checklist. Sixteen studies were included from a range of countries. One study was a full economic analysis. Fifteen studies were partial economic evaluations. These studies revealed that emergency abdominal surgery is expensive compared to similar elective surgery when comparing primary resource utilisation costs, with an important societal impact. Most contemporaneous studies indicate that in-hospital costs for EL are in excess of US$10,000 per patient episode, rising substantially when societal costs are considered. EL is a high-risk and costly procedure with a disproportionate financial burden for healthcare providers, relative to national funding provisions and wider societal cost impact. There is substantial heterogeneity in the methodologies and quality of published economic evaluations of EL; therefore, the true economic costs of EL are yet to be fully defined. Future research should focus on developing strategies to embed health economic evaluations within national programmes aiming to improve EL care, including developing the required measures and infrastructure. Emergency laparotomy is expensive, with a significant cost burden to healthcare and systems and society worldwide. Novel strategies for reducing this econmic burden should urgently be explored if greater access to this type of surgery is to be pursued as a global health target. PROSPERO

  18. Evaluation Methods for Assessing Users' Psychological Experiences of Web-Based Psychosocial Interventions: A Systematic Review.

    Science.gov (United States)

    Feather, Jacqueline Susan; Howson, Moira; Ritchie, Linda; Carter, Philip D; Parry, David Tudor; Koziol-McLain, Jane

    2016-06-30

    The use of Web-based interventions to deliver mental health and behavior change programs is increasingly popular. They are cost-effective, accessible, and generally effective. Often these interventions concern psychologically sensitive and challenging issues, such as depression or anxiety. The process by which a person receives and experiences therapy is important to understanding therapeutic process and outcomes. While the experience of the patient or client in traditional face-to-face therapy has been evaluated in a number of ways, there appeared to be a gap in the evaluation of patient experiences of therapeutic interventions delivered online. Evaluation of Web-based artifacts has focused either on evaluation of experience from a computer Web-design perspective through usability testing or on evaluation of treatment effectiveness. Neither of these methods focuses on the psychological experience of the person while engaged in the therapeutic process. This study aimed to investigate what methods, if any, have been used to evaluate the in situ psychological experience of users of Web-based self-help psychosocial interventions. A systematic literature review was undertaken of interdisciplinary databases with a focus on health and computer sciences. Studies that met a predetermined search protocol were included. Among 21 studies identified that examined psychological experience of the user, only 1 study collected user experience in situ. The most common method of understanding users' experience was through semistructured interviews conducted posttreatment or questionnaires administrated at the end of an intervention session. The questionnaires were usually based on standardized tools used to assess user experience with traditional face-to-face treatment. There is a lack of methods specified in the literature to evaluate the interface between Web-based mental health or behavior change artifacts and users. Main limitations in the research were the nascency of the topic

  19. Economic evaluations of pharmacist-managed services in people with diabetes mellitus: a systematic review.

    Science.gov (United States)

    Wang, Y; Yeo, Q Q; Ko, Y

    2016-04-01

    To review and evaluate the most recent literature on the economic outcomes of pharmacist-managed services in people with diabetes. The global prevalence of diabetes is increasing. Although pharmacist-managed services have been shown to improve people's health outcomes, the economic impact of these programmes remains unclear. A systematic review was conducted of six databases. Study inclusion criteria were: (1) original research; (2) evaluation of pharmacist-managed services in people with diabetes; (3) an economic evaluation; (4) English-language publication; and (5) full-text, published between January 2006 and December 2014. The quality of the full economic evaluations reviewed was evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist. A total of 2204 articles were screened and 25 studies were selected. These studies were conducted in a community pharmacy (n = 10), a clinic- /hospital-based outpatient facility (n = 8), or others. Pharmacist-managed services included targeted education (n = 24), general pharmacotherapeutic monitoring (n = 21), health screening or laboratory testing services (n = 9), immunization services (n = 2) and pharmacokinetic monitoring (n = 1). Compared with usual care, pharmacist-managed services resulted in cost savings that varied from $7 to $65,000 ($8 to $85,000 in 2014 US dollars) per person per year, and generated higher quality-adjusted life years with lower costs. Benefit-to-cost ratios ranged from 1:1 to 8.5:1. Among the 25 studies reviewed, 11 were full economic evaluations of moderate quality. Pharmacist-managed services had a positive return in terms of economic viability. With the expanding role of pharmacists in the healthcare sector, alongside increasing health expenditure, future economic studies of high quality are needed to investigate the cost-effectiveness of these services. © 2015 Diabetes UK.

  20. Systematic review of economic evaluation analyses of available vaccines in Spain from 1990 to 2012.

    Science.gov (United States)

    Cortés, Isabel; Pérez-Camarero, Santiago; Del Llano, Juan; Peña, Luz María; Hidalgo-Vega, Alvaro

    2013-08-02

    The objective of this survey was to describe the evolution of economic evaluation studies on vaccines available in Spain. We conducted a systematic review of the economic evaluations published by Spanish researchers in major bibliographic databases available online from 1990 to 2012. For all references identified, we limited them to full economic evaluation carried out in Spanish vaccine programs. The following variables were analyzed: type of study, year of publication, vaccine evaluated, the herd immunity and the main methodological aspects proposed by international guidelines. The type of vaccines studied were Hepatitis A and B, Rotavirus, Influenza, Varicella, Tetanus, Measles, Human papillomavirus, Streptococcus pneumoniae infection and Neisseria meningitides serogroup C infection. A total of 34 references was included in the study. The number of economic evaluations has been increasing over the years by 86%. For many of the vaccines there were no economic evaluations, while others such as the vaccine against S. pneumoniae infection took up most of the studies. The non-vaccinated comparison was the most used strategy. The cost-effectiveness model was selected in 60% of cases. The most common health outcome was "cost per case prevented" and in 82% of the studies did not consider herd immunity. The results showed a cost-effectiveness ratio which was below breakeven. It is clear that the existence of a huge gap in this kind of work compared to other countries. Although the quality of the work discussed here was significant, we found many areas which could be improved. The reviewed literature exposed the great benefit of vaccination for society by analysing the health outcomes achieved for decades since its implementation. However, the evidence on the efficiency and effectiveness vaccination is not very high, and there are few studies about economic evaluation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Predonation psychosocial evaluation of living kidney and liver donor candidates: a systematic literature review.

    Science.gov (United States)

    Duerinckx, Nathalie; Timmerman, Lotte; Van Gogh, Johan; van Busschbach, Jan; Ismail, Sohal Y; Massey, Emma K; Dobbels, Fabienne

    2014-01-01

    Evaluating a person's suitability for living organ donation is crucial, consisting not only of a medical but also of a thorough psychosocial screening. We performed a systematic literature review of guidelines, consensus statements, and protocols on the content and process of psychosocial screening of living kidney and liver donor candidates. We searched PubMed, Embase, CINAHL, and PsycINFO until June 22, 2011, following the PRISMA guidelines, complemented by scrutinizing guidelines databases and references of identified publications. Thirty-four publications were identified, including seven guidelines, six consensus statements, and 21 protocols or programs. Guidelines and consensus statements were inconsistent and lacked concreteness for both their content and process, possibly explaining the observed variability in center-specific evaluation protocols and programs. Overall, recommended screening criteria are not evidence-based and an operational definition of the concept "psychosocial" is missing, causing heterogeneity in terminology. Variation also exists on methods used to psychosocially evaluate potential donors. The scientific basis of predonation psychosocial evaluation needs to be strengthened. There is a need for high-quality prospective psychosocial outcome studies in living donors, a uniform terminology to label psychosocial screening criteria, and validated instruments to identify risk factors. © 2013 Steunstichting ESOT. Published by John Wiley & Sons Ltd.

  2. Economic evaluation of HBV vaccination: A systematic review of recent publications (2000-2013).

    Science.gov (United States)

    La Torre, Giuseppe; Mannocci, Alice; Saulle, Rosella; Colamesta, Vittoria; Meggiolaro, Angela; Mipatrini, Daniele; Sinopoli, Alessandra

    2016-09-01

    To conduct a systematic review of the economic evaluations (EE) of HBV vaccination, taking also into account the studies published in the new millennium. An extensive scientific literature review was conducted using two electronic medical journal databases: Scopus and PubMed engines for published studies on EE of HBV vaccination. 22 articles were reviewed, 9, 5 and 8 cost-effectiveness, cost-benefit and cost-utility analysis, respectively. Studies were mainly concerning EE of universal vaccination (UV), mostly with regards to low or low-medium income countries. For high income countries, EE were focused on the possible implementation of HBV vaccination in particular settings, such as diabetic, renal and other chronic conditions care, as well as infectious diseasesUV has usually a very good cost-effectiveness ratio (80%), ranging from cost-saving (China) or few Euro per LY/QALY gained (in Thailand, and Vietnam) to 630.00$/QALY in USA (Asian and Pacific Islands) Moreover, EE of HBV vaccination are favorable in the infectious diseases field as well as for chronic conditions. In relation to diabetes the studies gave controversial results. This systematic review highlighted the importance of introducing HBV vaccination not only for infant UV program but also for other settings in which patients are people affected by communicable and non-communicable diseases.

  3. Low health literacy and evaluation of online health information: a systematic review of the literature.

    Science.gov (United States)

    Diviani, Nicola; van den Putte, Bas; Giani, Stefano; van Weert, Julia Cm

    2015-05-07

    Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information. The main aim of this study was to review existing evidence on the association between low health literacy and (1) people's ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information. Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels. After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive. The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review

  4. Development of scenarios for emergency exercises and the systematic evaluation of the results

    Energy Technology Data Exchange (ETDEWEB)

    Schmidtborn, I.; Playfair, A. [Colenco Power Consulting AG, Baden (Switzerland)

    2001-07-01

    This paper describes a systematic method for preparing emergency exercises for the training of power station personnel in the establishment of internal and external communications and the initiation of emergency measures in the case of beyond design basis accidents. The exercises are planned over a period of time in such a way that a wide range of scenarios are covered, keeping repetition to a minimum and the work for preparing the individual exercises is reduced as far as possible. To give an idea of the variety of exercises that can be developed using this method, a selection of the exercise titles that have been used by Colenco over the past 10 years is given. A great deal of importance has to be attached to the evaluation of the exercises.

  5. Development of scenarios for emergency exercises and the systematic evaluation of the results

    International Nuclear Information System (INIS)

    Schmidtborn, I.; Playfair, A.

    2001-01-01

    This paper describes a systematic method for preparing emergency exercises for the training of power station personnel in the establishment of internal and external communications and the initiation of emergency measures in the case of beyond design basis accidents. The exercises are planned over a period of time in such a way that a wide range of scenarios are covered, keeping repetition to a minimum and the work for preparing the individual exercises is reduced as far as possible. To give an idea of the variety of exercises that can be developed using this method, a selection of the exercise titles that have been used by Colenco over the past 10 years is given. A great deal of importance has to be attached to the evaluation of the exercises

  6. A Systematic Evaluation of Mobile Applications for Instant Messaging on iOS Devices

    Directory of Open Access Journals (Sweden)

    Sergio Caro-Alvaro

    2017-01-01

    Full Text Available Nowadays, instant messaging applications (apps are one of the most popular applications for mobile devices with millions of active users. However, mobile devices present hardware and software characteristics and limitations compared with personal computers. Hence, to address the usability issues of mobile apps, a specific methodology must be conducted. This paper shows the findings from a systematic analysis of these applications on iOS mobile platform that was conducted to identify some usability issues in mobile applications for instant messaging. The overall process includes a Keystroke-Level Modeling and a Mobile Heuristic Evaluation. In the same trend, we propose a set of guidelines for improving the usability of these apps. Based on our findings, this analysis will help in the future to create more effective mobile applications for instant messaging.

  7. Economic evaluations of comprehensive geriatric assessment in surgical patients: a systematic review.

    Science.gov (United States)

    Eamer, Gilgamesh; Saravana-Bawan, Bianka; van der Westhuizen, Brenden; Chambers, Thane; Ohinmaa, Arto; Khadaroo, Rachel G

    2017-10-01

    Seniors presenting with surgical disease face increased risk of postoperative morbidity and mortality and have increased treatment costs. Comprehensive Geriatric Assessment (CGA) is proposed to reduce morbidity, mortality, and the cost after surgery. A systematic review of CGA in emergency surgical patients was conducted. The primary outcome was cost-effectiveness; secondary outcomes were length of stay, return of function, and mortality. Inclusion and exclusion criteria were predefined. Systematic searches of MEDLINE, Embase, Cochrane, and National Health Service Economic Evaluation Database were performed. Text screening, bias assessment, and data extraction were performed by two authors. There were 560 articles identified; abstract review excluded 499 articles and full-text review excluded 53 articles. Eight studies were included; one nonorthopedic trauma and seven orthopedic trauma studies. Bias assessment revealed moderate to high risk of bias for all studies. Economic evaluation assessment identified two high-quality studies and six moderate or low quality studies. Pooled analysis from four studies assessed loss of function; loss of function decreased in the experimental arm (odds ratio 0.92, 95% confidence interval [CI]: 0.88-0.97). Pooled results for length of stay from five studies found a significant decrease (mean difference: -1.17, 95% CI: -1.63 to -0.71) after excluding the nonorthopedic trauma study. Pooled mortality was significantly decreased in seven studies (risk ratio: 0.78, 95% CI: 0.67-0.90). All studies decreased cost and improved health outcomes in a cost-effective manner. CGA improved return of function and mortality with reduced cost or improved utility. Our review suggests that CGA is economically dominant and the most cost-effective care model for orthogeriatric patients. Further research should examine other surgical fields. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Wearable Inertial Sensor Systems for Lower Limb Exercise Detection and Evaluation: A Systematic Review.

    Science.gov (United States)

    O'Reilly, Martin; Caulfield, Brian; Ward, Tomas; Johnston, William; Doherty, Cailbhe

    2018-05-01

    Analysis of lower limb exercises is traditionally completed with four distinct methods: (1) 3D motion capture; (2) depth-camera-based systems; (3) visual analysis from a qualified exercise professional; and (4) self-assessment. Each method is associated with a number of limitations. The aim of this systematic review is to synthesise and evaluate studies which have investigated the capacity for inertial measurement unit (IMU) technologies to assess movement quality in lower limb exercises. A systematic review of studies identified through the databases of PubMed, ScienceDirect and Scopus was conducted. Articles written in English and published in the last 10 years which investigated an IMU system for the analysis of repetition-based targeted lower limb exercises were included. The quality of included studies was measured using an adapted version of the STROBE assessment criteria for cross-sectional studies. The studies were categorised into three groupings: exercise detection, movement classification or measurement validation. Each study was then qualitatively summarised. From the 2452 articles that were identified with the search strategies, 47 papers are included in this review. Twenty-six of the 47 included studies were deemed as being of high quality. Wearable inertial sensor systems for analysing lower limb exercises is a rapidly growing field of research. Research over the past 10 years has predominantly focused on validating measurements that the systems produce and classifying users' exercise quality. There have been very few user evaluation studies and no clinical trials in this field to date.

  9. Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review.

    Science.gov (United States)

    Cordier, Reinie; Speyer, Renée; Chen, Yu-Wei; Wilkes-Gillan, Sarah; Brown, Ted; Bourke-Taylor, Helen; Doma, Kenji; Leicht, Anthony

    2015-01-01

    Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning. To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults. A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity. The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments.

  10. Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review

    Science.gov (United States)

    Brown, Ted; Bourke-Taylor, Helen; Doma, Kenji; Leicht, Anthony

    2015-01-01

    Introduction Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning. Objective To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults. Methods A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Results Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity. Conclusions The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments. PMID:26151362

  11. Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Reinie Cordier

    Full Text Available Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning.To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults.A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria.Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity.The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments.

  12. Methods for the evaluation of hospital cooperation activities (Systematic review protocol

    Directory of Open Access Journals (Sweden)

    Rotter Thomas

    2012-02-01

    Full Text Available Abstract Background Hospital partnerships, mergers and cooperatives are arrangements frequently seen as a means of improving health service delivery. Many of the assumptions used in planning hospital cooperatives are not stated clearly and are often based on limited or poor scientific evidence. Methods This is a protocol for a systematic review, following the Cochrane EPOC methodology. The review aims to document, catalogue and synthesize the existing literature on the reported methods for the evaluation of hospital cooperation activities as well as methods of hospital cooperation. We will search the Database of Abstracts of Reviews of Effectiveness, the Effective Practice and Organisation of Care Register, the Cochrane Central Register of Controlled Trials and bibliographic databases including PubMed (via NLM, Web of Science, NHS EED, Business Source Premier (via EBSCO and Global Health for publications that report on methods for evaluating hospital cooperatives, strategic partnerships, mergers, alliances, networks and related activities and methods used for such partnerships. The method proposed by the Cochrane EPOC group regarding randomized study designs, controlled clinical trials, controlled before and after studies, and interrupted time series will be followed. In addition, we will also include cohort, case-control studies, and relevant non-comparative publications such as case reports. We will categorize and analyze the review findings according to the study design employed, the study quality (low versus high quality studies and the method reported in the primary studies. We will present the results of studies in tabular form. Discussion Overall, the systematic review aims to identify, assess and synthesize the evidence to underpin hospital cooperation activities as defined in this protocol. As a result, the review will provide an evidence base for partnerships, alliances or other fields of cooperation in a hospital setting. PROSPERO

  13. An analytical evaluation for spatial-dependent intra-pebble Dancoff factor and escape probability

    International Nuclear Information System (INIS)

    Kim, Songhyun; Kim, Hong-Chul; Kim, Jong Kyung; Kim, Soon Young; Noh, Jae Man

    2009-01-01

    The analytical evaluation of spatial-dependent intra-pebble Dancoff factors and their escape probabilities is pursued by the model developed in this study. Intra-pebble Dancoff factors and their escape probabilities are calculated as a function of fuel kernel radius, number of fuel kernels, and fuel region radius. The method in this study can be easily utilized to analyze the tendency of spatial-dependent intra-pebble Dancoff factor and spatial-dependent fuel region escape probability for the various geometries because it is faster than the MCNP method as well as good accuracy. (author)

  14. Systematic Evaluation Program (SEP) at Rocky Flats Plant: An overview of practical management issues for evaluation of natural phenomena hazards

    International Nuclear Information System (INIS)

    Badwan, F.M.

    1993-01-01

    Many of the buildings at the Rocky Flats Plant were designed and built before modern standards were developed, including standards for protection against extreme natural phenomenon such as tornadoes, earthquakes, and floods. The purpose of the SEP is to establish an integrated approach to assessing the design adequacy of specific high and moderate hazard Rocky Flats facilities from a safety perspective and to establish a basis for defining any needed facility improvements. The SEP is to be carried out in three Phases. In Phase 1, topics to be evaluated and an evaluation plan for each topic were developed. Any differences between Current Design Requirements (CDR) or acceptance criteria and the design of existing facilities, will be identified during Phase 2 and assessed using an integrated systematic approach during Phase 3. The integrated assessment performed during Phase 3 provides a process for evaluating the differences between existing facility design and CDRs so that decisions on corrective actions can be made on the basis of relative risk reduction and cost effectiveness. These efforts will ensure that a balanced and integrated level of safety is achieved for long-term operation of these buildings. Through appropriate selection of topics and identification of the structures, systems, and components to be evaluated, the SEP will address outstanding design issues related to the prevention and mitigation of design basis accidents, including those arising from natural phenomena. The objective of the SEP is not to bring these buildings into strict compliance with current requirements, but rather to ensure that an adequate level of safety is achieved in an economical fashion

  15. A systematic evaluation of normalization methods in quantitative label-free proteomics.

    Science.gov (United States)

    Välikangas, Tommi; Suomi, Tomi; Elo, Laura L

    2018-01-01

    To date, mass spectrometry (MS) data remain inherently biased as a result of reasons ranging from sample handling to differences caused by the instrumentation. Normalization is the process that aims to account for the bias and make samples more comparable. The selection of a proper normalization method is a pivotal task for the reliability of the downstream analysis and results. Many normalization methods commonly used in proteomics have been adapted from the DNA microarray techniques. Previous studies comparing normalization methods in proteomics have focused mainly on intragroup variation. In this study, several popular and widely used normalization methods representing different strategies in normalization are evaluated using three spike-in and one experimental mouse label-free proteomic data sets. The normalization methods are evaluated in terms of their ability to reduce variation between technical replicates, their effect on differential expression analysis and their effect on the estimation of logarithmic fold changes. Additionally, we examined whether normalizing the whole data globally or in segments for the differential expression analysis has an effect on the performance of the normalization methods. We found that variance stabilization normalization (Vsn) reduced variation the most between technical replicates in all examined data sets. Vsn also performed consistently well in the differential expression analysis. Linear regression normalization and local regression normalization performed also systematically well. Finally, we discuss the choice of a normalization method and some qualities of a suitable normalization method in the light of the results of our evaluation. © The Author 2016. Published by Oxford University Press.

  16. Systematic analysis and the overall toxicity evaluation of dioxins and hexachlorobenzene in human milk

    Energy Technology Data Exchange (ETDEWEB)

    Saito, K.; Ogawa, M.; Takekuma, M.; Ohmura, A. [Dioxin Reasearch Group, Saitama Institute of Public Health, Saitama (Japan); Kawaguchi, M.; Ito, R.; Nakazawa, H. [Hoshi Univ., Tokyo (Japan). Dept. of Analytical Chemistry; Matsuki, Y. [Japan Food Hygiene Association, Tokyo (Japan). Inst. of Food Hygiene

    2004-09-15

    The hexachlorobenzene (HCB), a type of organochlorine pesticide (OCP), was used as a fungicide for seed, and as a wood preservative. Also, HCB exists in the by-products found in the manufacturing process of chlorinated organic chemicals, and is generated by garbage incineration. The HCB is a so-called, unintended toxic pollutant as well as dioxins, and HCB is then specified for Persistent Organic Pollutants (POPs). According to a recent study, it was pointed out that HCB binds to the aryl hydrocarbon (Ah) receptor, resulting in dioxin-like effects and bioaccumulates. Therefore, the overall toxicity evaluation of dioxins and HCB in human body, especially in human milk, should be examined, because HCB is universally detected in human milk. Until now, many studies regarding the dioxins or OCPs polluted in human milk have been reported. However, there are only a few reports that analyze both dioxins and HCB in the same sample, because repeated sampling and large amounts of samples of human milk were generally difficult to acquire. Moreover, few studies are available for the overall toxicity evaluation of dioxins and HCB in human milk. The aim of the present study was to develop the systematic analysis method of dioxins and HCB, and to obtain additional information about the overall toxicity evaluation of dioxins and HCB in human milk. The correlation between the HCB residue level and each dioxin isomer in the human milk was also considered.

  17. Critical systematic evaluation and thermodynamic optimization of the Mn–RE system: RE = La, Ce, Pr, Nd and Sm

    International Nuclear Information System (INIS)

    Kim, Junghwan; Jung, In-Ho

    2012-01-01

    Highlights: ► The Mn–RE (RE = La, Ce, Pr, Nd and Sm) systems have been critically reviewed. ► The thermodynamic optimization of the Mn–RE systems have been performed. ► Systematic changes in the phase diagrams and thermodynamic properties were found. ► The systematic approach resolved inconsistencies in the experimental data. - Abstract: Critical evaluation and optimization of all available phase diagram and thermodynamic data for the Mn–RE (RE = La, Ce, Pr, Nd and Sm) systems have been conducted to obtain reliable thermodynamic functions of all the phases in the system. In the thermodynamic modeling, it is found that the Mn–RE systems show systematic changes in the phase diagrams and thermodynamic properties such as enthalpy of mixing in liquid state in the order of periodic number in the lanthanide series. This systematic thermodynamic modeling approach for all light RE elements can allow to resolve inconsistencies in the experimental data.

  18. Scientific Evaluation and Review of Claims in Health Care (SEaRCH): A Streamlined, Systematic, Phased Approach for Determining “What Works” in Healthcare

    Science.gov (United States)

    Crawford, Cindy; Hilton, Lara; Elfenbaum, Pamela

    2017-01-01

    Abstract Background: Answering the question of “what works” in healthcare can be complex and requires the careful design and sequential application of systematic methodologies. Over the last decade, the Samueli Institute has, along with multiple partners, developed a streamlined, systematic, phased approach to this process called the Scientific Evaluation and Review of Claims in Health Care (SEaRCH™). The SEaRCH process provides an approach for rigorously, efficiently, and transparently making evidence-based decisions about healthcare claims in research and practice with minimal bias. Methods: SEaRCH uses three methods combined in a coordinated fashion to help determine what works in healthcare. The first, the Claims Assessment Profile (CAP), seeks to clarify the healthcare claim and question, and its ability to be evaluated in the context of its delivery. The second method, the Rapid Evidence Assessment of the Literature (REAL©), is a streamlined, systematic review process conducted to determine the quantity, quality, and strength of evidence and risk/benefit for the treatment. The third method involves the structured use of expert panels (EPs). There are several types of EPs, depending on the purpose and need. Together, these three methods—CAP, REAL, and EP—can be integrated into a strategic approach to help answer the question “what works in healthcare?” and what it means in a comprehensive way. Discussion: SEaRCH is a systematic, rigorous approach for evaluating healthcare claims of therapies, practices, programs, or products in an efficient and stepwise fashion. It provides an iterative, protocol-driven process that is customized to the intervention, consumer, and context. Multiple communities, including those involved in health service and policy, can benefit from this organized framework, assuring that evidence-based principles determine which healthcare practices with the greatest promise are used for improving the public's health and

  19. Scientific Evaluation and Review of Claims in Health Care (SEaRCH): A Streamlined, Systematic, Phased Approach for Determining "What Works" in Healthcare.

    Science.gov (United States)

    Jonas, Wayne B; Crawford, Cindy; Hilton, Lara; Elfenbaum, Pamela

    2017-01-01

    Answering the question of "what works" in healthcare can be complex and requires the careful design and sequential application of systematic methodologies. Over the last decade, the Samueli Institute has, along with multiple partners, developed a streamlined, systematic, phased approach to this process called the Scientific Evaluation and Review of Claims in Health Care (SEaRCH™). The SEaRCH process provides an approach for rigorously, efficiently, and transparently making evidence-based decisions about healthcare claims in research and practice with minimal bias. SEaRCH uses three methods combined in a coordinated fashion to help determine what works in healthcare. The first, the Claims Assessment Profile (CAP), seeks to clarify the healthcare claim and question, and its ability to be evaluated in the context of its delivery. The second method, the Rapid Evidence Assessment of the Literature (REAL © ), is a streamlined, systematic review process conducted to determine the quantity, quality, and strength of evidence and risk/benefit for the treatment. The third method involves the structured use of expert panels (EPs). There are several types of EPs, depending on the purpose and need. Together, these three methods-CAP, REAL, and EP-can be integrated into a strategic approach to help answer the question "what works in healthcare?" and what it means in a comprehensive way. SEaRCH is a systematic, rigorous approach for evaluating healthcare claims of therapies, practices, programs, or products in an efficient and stepwise fashion. It provides an iterative, protocol-driven process that is customized to the intervention, consumer, and context. Multiple communities, including those involved in health service and policy, can benefit from this organized framework, assuring that evidence-based principles determine which healthcare practices with the greatest promise are used for improving the public's health and wellness.

  20. Methods Used in Economic Evaluations of Chronic Kidney Disease Testing — A Systematic Review

    Science.gov (United States)

    Sutton, Andrew J.; Breheny, Katie; Deeks, Jon; Khunti, Kamlesh; Sharpe, Claire; Ottridge, Ryan S.; Stevens, Paul E.; Cockwell, Paul; Kalra, Philp A.; Lamb, Edmund J.

    2015-01-01

    Background The prevalence of chronic kidney disease (CKD) is high in general populations around the world. Targeted testing and screening for CKD are often conducted to help identify individuals that may benefit from treatment to ameliorate or prevent their disease progression. Aims This systematic review examines the methods used in economic evaluations of testing and screening in CKD, with a particular focus on whether test accuracy has been considered, and how analysis has incorporated issues that may be important to the patient, such as the impact of testing on quality of life and the costs they incur. Methods Articles that described model-based economic evaluations of patient testing interventions focused on CKD were identified through the searching of electronic databases and the hand searching of the bibliographies of the included studies. Results The initial electronic searches identified 2,671 papers of which 21 were included in the final review. Eighteen studies focused on proteinuria, three evaluated glomerular filtration rate testing and one included both tests. The full impact of inaccurate test results was frequently not considered in economic evaluations in this setting as a societal perspective was rarely adopted. The impact of false positive tests on patients in terms of the costs incurred in re-attending for repeat testing, and the anxiety associated with a positive test was almost always overlooked. In one study where the impact of a false positive test on patient quality of life was examined in sensitivity analysis, it had a significant impact on the conclusions drawn from the model. Conclusion Future economic evaluations of kidney function testing should examine testing and monitoring pathways from the perspective of patients, to ensure that issues that are important to patients, such as the possibility of inaccurate test results, are properly considered in the analysis. PMID:26465773

  1. Evaluation of Wet Cupping Therapy: Systematic Review of Randomized Clinical Trials.

    Science.gov (United States)

    Al Bedah, Abdullah M N; Khalil, Mohamed K M; Posadzki, Paul; Sohaibani, Imen; Aboushanab, Tamer Shaaban; AlQaed, Meshari; Ali, Gazzaffi I M

    2016-10-01

    Wet cupping is a widely used traditional therapy in many countries, which justifies a continuous scientific evaluation of its efficacy and safety. To perform a systematic review to critically evaluate and update the available evidence of wet cupping in traditional and complementary medicine. Ten electronic databases were searched from their inceptions to February 2016. Included studies were randomized clinical trials (RCTs) that evaluated wet cupping against any type of control interventions in patients with any clinical condition, as well as healthy individuals. Cochrane risk of bias tool was used to appraise the included RCTs. Fourteen RCTs met the eligibility criteria. The included studies evaluated the following clinical conditions: nonspecific low back pain (NSLBP), hypertension, brachialgia, carpal tunnel syndrome (CTS), chronic neck pain, metabolic syndrome, migraine headaches, oxygen saturation in smokers with chronic obstructive pulmonary disease (COPD), and oral and genital ulcers due to Behçet disease. Two RCTs evaluated physiologic and biochemical parameters of healthy individuals. Overall, 9 RCTs favored wet cupping over various control interventions in NSLBP (n = 2), hypertension (n = 1), brachialgia (n = 1), CTS (n = 1), chronic neck pain (n = 2), oxygen saturation in smokers with COPD (n = 1), and oral and genital ulcers due to Behçet disease (n = 1). Five RCTs showed no statistically significant between-group differences: NSLBP (n = 1), metabolic syndrome (n = 1), migraine headaches (n = 1), and physiologic and biochemical parameters of healthy individuals (n = 2). Included RCTs had a variable risk of bias across all domains and suffered methodologic limitations. There is a promising evidence in favor of the use of wet cupping for musculoskeletal pain, specifically NSLBP, neck pain, CTS, and brachialgia. Better-quality trials are needed to generate solid evidence and firmly inform policy makers.

  2. Evaluating mobile phone applications for health behaviour change: A systematic review.

    Science.gov (United States)

    McKay, Fiona H; Cheng, Christina; Wright, Annemarie; Shill, Jane; Stephens, Hugh; Uccellini, Mary

    2018-01-01

    Introduction Increasing smartphones access has allowed for increasing development and use of smart phone applications (apps). Mobile health interventions have previously relied on voice or text-based short message services (SMS), however, the increasing availability and ease of use of apps has allowed for significant growth of smartphone apps that can be used for health behaviour change. This review considers the current body of knowledge relating to the evaluation of apps for health behaviour change. The aim of this review is to investigate approaches to the evaluation of health apps to identify any current best practice approaches. Method A systematic review was conducted. Data were collected and analysed in September 2016. Thirty-eight articles were identified and have been included in this review. Results Articles were published between 2011- 2016, and 36 were reviews or evaluations of apps related to one or more health conditions, the remaining two reported on an investigation of the usability of health apps. Studies investigated apps relating to the following areas: alcohol, asthma, breastfeeding, cancer, depression, diabetes, general health and fitness, headaches, heart disease, HIV, hypertension, iron deficiency/anaemia, low vision, mindfulness, obesity, pain, physical activity, smoking, weight management and women's health. Conclusion In order to harness the potential of mobile health apps for behaviour change and health, we need better ways to assess the quality and effectiveness of apps. This review is unable to suggest a single best practice approach to evaluate mobile health apps. Few measures identified in this review included sufficient information or evaluation, leading to potentially incomplete and inaccurate information for consumers seeking the best app for their situation. This is further complicated by a lack of regulation in health promotion generally.

  3. Recommendations for Pathologic Evaluation of Reduction Mammoplasty Specimens: A Prospective Study With Systematic Tissue Sampling.

    Science.gov (United States)

    Ambaye, Abiy B; Goodwin, Andrew J; MacLennan, Susan E; Naud, Shelly; Weaver, Donald L

    2017-11-01

    - Breast reduction mammaplasty (RMP) for symptomatic macromastia or correction of asymmetry is performed in more than 100 000 patients per year in the United States. The reported incidence of significant pathologic findings (SPF), that is, carcinoma and atypical hyperplasia, ranges from 0.06% to 12.8%. No standard pathology assessment for RMP exists. - To propose standard sampling for microscopic evaluation in RMP specimens, to evaluate the incidence of occult carcinoma and atypical hyperplasia, and to identify clinical risk factors for SPF in patients undergoing RMP. - All RMP specimens from 2006 to 2013 at a single institution were prospectively examined. After baseline gross and microscopic evaluations, each specimen was subjected to systematic additional sampling. The incidence of SPF was tabulated, and variables such as age, specimen weight, previous history of SPF, and results of preoperative mammogram were examined. Clinical follow-up review was also subsequently undertaken. - A total of 595 patients were evaluated. Significant pathologic findings were present in 9.8% (58 of 595) of patients. No cancer was identified in patients younger than 40 years; the rates of carcinoma were 2.4% (14 of 595) in all patients, 3.6% (14 of 392) in patients aged 40 years or older, and 4.3% (10 of 233) in patients aged 50 years or older. No carcinoma or atypical hyperplasia was identified on preoperative mammogram. Increased sampling was associated with a significantly greater frequency of SPF only in patients aged 40 years or older. - In patients younger than 35 years, gross-only evaluation is sufficient. However, increased sampling may be necessary in patients older than 40 years.

  4. Evidence used in model-based economic evaluations for evaluating pharmacogenetic and pharmacogenomic tests: a systematic review protocol.

    Science.gov (United States)

    Peters, Jaime L; Cooper, Chris; Buchanan, James

    2015-11-11

    Decision models can be used to conduct economic evaluations of new pharmacogenetic and pharmacogenomic tests to ensure they offer value for money to healthcare systems. These models require a great deal of evidence, yet research suggests the evidence used is diverse and of uncertain quality. By conducting a systematic review, we aim to investigate the test-related evidence used to inform decision models developed for the economic evaluation of genetic tests. We will search electronic databases including MEDLINE, EMBASE and NHS EEDs to identify model-based economic evaluations of pharmacogenetic and pharmacogenomic tests. The search will not be limited by language or date. Title and abstract screening will be conducted independently by 2 reviewers, with screening of full texts and data extraction conducted by 1 reviewer, and checked by another. Characteristics of the decision problem, the decision model and the test evidence used to inform the model will be extracted. Specifically, we will identify the reported evidence sources for the test-related evidence used, describe the study design and how the evidence was identified. A checklist developed specifically for decision analytic models will be used to critically appraise the models described in these studies. Variations in the test evidence used in the decision models will be explored across the included studies, and we will identify gaps in the evidence in terms of both quantity and quality. The findings of this work will be disseminated via a peer-reviewed journal publication and at national and international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Experimental evaluation of optimal Vehicle Dynamic Control based on the State Dependent Riccati Equation technique

    NARCIS (Netherlands)

    Alirezaei, M.; Kanarachos, S.A.; Scheepers, B.T.M.; Maurice, J.P.

    2013-01-01

    Development and experimentally evaluation of an optimal Vehicle Dynamic Control (VDC) strategy based on the State Dependent Riccati Equation (SDRE) control technique is presented. The proposed nonlinear controller is based on a nonlinear vehicle model with nonlinear tire characteristics. A novel

  6. STEM - software test and evaluation methods. A study of failure dependency in diverse software

    International Nuclear Information System (INIS)

    Bishop, P.G.; Pullen, F.D.

    1989-02-01

    STEM is a collaborative software reliability project undertaken in partnership with Halden Reactor Project, UKAEA, and the Finnish Technical Research Centre. The objective of STEM is to evaluate a number of fault detection and fault estimation methods which can be applied to high integrity software. This Report presents a study of the observed failure dependencies between faults in diversely produced software. (author)

  7. SU-D-BRD-07: Evaluation of the Effectiveness of Statistical Process Control Methods to Detect Systematic Errors For Routine Electron Energy Verification

    International Nuclear Information System (INIS)

    Parker, S

    2015-01-01

    Purpose: To evaluate the ability of statistical process control methods to detect systematic errors when using a two dimensional (2D) detector array for routine electron beam energy verification. Methods: Electron beam energy constancy was measured using an aluminum wedge and a 2D diode array on four linear accelerators. Process control limits were established. Measurements were recorded in control charts and compared with both calculated process control limits and TG-142 recommended specification limits. The data was tested for normality, process capability and process acceptability. Additional measurements were recorded while systematic errors were intentionally introduced. Systematic errors included shifts in the alignment of the wedge, incorrect orientation of the wedge, and incorrect array calibration. Results: Control limits calculated for each beam were smaller than the recommended specification limits. Process capability and process acceptability ratios were greater than one in all cases. All data was normally distributed. Shifts in the alignment of the wedge were most apparent for low energies. The smallest shift (0.5 mm) was detectable using process control limits in some cases, while the largest shift (2 mm) was detectable using specification limits in only one case. The wedge orientation tested did not affect the measurements as this did not affect the thickness of aluminum over the detectors of interest. Array calibration dependence varied with energy and selected array calibration. 6 MeV was the least sensitive to array calibration selection while 16 MeV was the most sensitive. Conclusion: Statistical process control methods demonstrated that the data distribution was normally distributed, the process was capable of meeting specifications, and that the process was centered within the specification limits. Though not all systematic errors were distinguishable from random errors, process control limits increased the ability to detect systematic errors

  8. Economic Evaluations of Pharmacogenetic and Pharmacogenomic Screening Tests: A Systematic Review. Second Update of the Literature.

    Directory of Open Access Journals (Sweden)

    Elizabeth J J Berm

    Full Text Available Due to extended application of pharmacogenetic and pharmacogenomic screening (PGx tests it is important to assess whether they provide good value for money. This review provides an update of the literature.A literature search was performed in PubMed and papers published between August 2010 and September 2014, investigating the cost-effectiveness of PGx screening tests, were included. Papers from 2000 until July 2010 were included via two previous systematic reviews. Studies' overall quality was assessed with the Quality of Health Economic Studies (QHES instrument.We found 38 studies, which combined with the previous 42 studies resulted in a total of 80 included studies. An average QHES score of 76 was found. Since 2010, more studies were funded by pharmaceutical companies. Most recent studies performed cost-utility analysis, univariate and probabilistic sensitivity analyses, and discussed limitations of their economic evaluations. Most studies indicated favorable cost-effectiveness. Majority of evaluations did not provide information regarding the intrinsic value of the PGx test. There were considerable differences in the costs for PGx testing. Reporting of the direction and magnitude of bias on the cost-effectiveness estimates as well as motivation for the chosen economic model and perspective were frequently missing.Application of PGx tests was mostly found to be a cost-effective or cost-saving strategy. We found that only the minority of recent pharmacoeconomic evaluations assessed the intrinsic value of the PGx tests. There was an increase in the number of studies and in the reporting of quality associated characteristics. To improve future evaluations, scenario analysis including a broad range of PGx tests costs and equal costs of comparator drugs to assess the intrinsic value of the PGx tests, are recommended. In addition, robust clinical evidence regarding PGx tests' efficacy remains of utmost importance.

  9. Integrating social justice concerns into economic evaluation for healthcare and public health: A systematic review.

    Science.gov (United States)

    Dukhanin, Vadim; Searle, Alexandra; Zwerling, Alice; Dowdy, David W; Taylor, Holly A; Merritt, Maria W

    2018-02-01

    Social justice is the moral imperative to avoid and remediate unfair distributions of societal disadvantage. In priority setting in healthcare and public health, social justice reaches beyond fairness in the distribution of health outcomes and economic impacts to encompass fairness in the distribution of policy impacts upon other dimensions of well-being. There is an emerging awareness of the need for economic evaluation to integrate all such concerns. We performed a systematic review (1) to describe methodological solutions suitable for integrating social justice concerns into economic evaluation, and (2) to describe the challenges that those solutions face. To be included, publications must have captured fairness considerations that (a) involve cross-dimensional subjective personal life experience and (b) can be manifested at the level of subpopulations. We identified relevant publications using an electronic search in EMBASE, PubMed, EconLit, PsycInfo, Philosopher's Index, and Scopus, including publications available in English in the past 20 years. Two reviewers independently appraised candidate publications, extracted data, and synthesized findings in narrative form. Out of 2388 publications reviewed, 26 were included. Solutions sought either to incorporate relevant fairness considerations directly into economic evaluation or to report them alongside cost-effectiveness measures. The majority of reviewed solutions, if adapted to integrate social justice concerns, would require their explicit quantification. Four broad challenges related to the implementation of these solutions were identified: clarifying the normative basis; measuring and determining the relative importance of criteria representing that basis; combining the criteria; and evaluating trade-offs. All included solutions must grapple with an inherent tension: they must either face the normative and operational challenges of quantifying social justice concerns or accede to offering incomplete policy

  10. Reproducibility of studies on text mining for citation screening in systematic reviews: Evaluation and checklist.

    Science.gov (United States)

    Olorisade, Babatunde Kazeem; Brereton, Pearl; Andras, Peter

    2017-09-01

    Independent validation of published scientific results through study replication is a pre-condition for accepting the validity of such results. In computation research, full replication is often unrealistic for independent results validation, therefore, study reproduction has been justified as the minimum acceptable standard to evaluate the validity of scientific claims. The application of text mining techniques to citation screening in the context of systematic literature reviews is a relatively young and growing computational field with high relevance for software engineering, medical research and other fields. However, there is little work so far on reproduction studies in the field. In this paper, we investigate the reproducibility of studies in this area based on information contained in published articles and we propose reporting guidelines that could improve reproducibility. The study was approached in two ways. Initially we attempted to reproduce results from six studies, which were based on the same raw dataset. Then, based on this experience, we identified steps considered essential to successful reproduction of text mining experiments and characterized them to measure how reproducible is a study given the information provided on these steps. 33 articles were systematically assessed for reproducibility using this approach. Our work revealed that it is currently difficult if not impossible to independently reproduce the results published in any of the studies investigated. The lack of information about the datasets used limits reproducibility of about 80% of the studies assessed. Also, information about the machine learning algorithms is inadequate in about 27% of the papers. On the plus side, the third party software tools used are mostly free and available. The reproducibility potential of most of the studies can be significantly improved if more attention is paid to information provided on the datasets used, how they were partitioned and utilized, and

  11. The reliability of WorkWell Systems Functional Capacity Evaluation: a systematic review

    Science.gov (United States)

    2014-01-01

    Background Functional capacity evaluation (FCE) determines a person’s ability to perform work-related tasks and is a major component of the rehabilitation process. The WorkWell Systems (WWS) FCE (formerly known as Isernhagen Work Systems FCE) is currently the most commonly used FCE tool in German rehabilitation centres. Our systematic review investigated the inter-rater, intra-rater and test-retest reliability of the WWS FCE. Methods We performed a systematic literature search of studies on the reliability of the WWS FCE and extracted item-specific measures of inter-rater, intra-rater and test-retest reliability from the identified studies. Intraclass correlation coefficients ≥ 0.75, percentages of agreement ≥ 80%, and kappa coefficients ≥ 0.60 were categorised as acceptable, otherwise they were considered non-acceptable. The extracted values were summarised for the five performance categories of the WWS FCE, and the results were classified as either consistent or inconsistent. Results From 11 identified studies, 150 item-specific reliability measures were extracted. 89% of the extracted inter-rater reliability measures, all of the intra-rater reliability measures and 96% of the test-retest reliability measures of the weight handling and strength tests had an acceptable level of reliability, compared to only 67% of the test-retest reliability measures of the posture/mobility tests and 56% of the test-retest reliability measures of the locomotion tests. Both of the extracted test-retest reliability measures of the balance test were acceptable. Conclusions Weight handling and strength tests were found to have consistently acceptable reliability. Further research is needed to explore the reliability of the other tests as inconsistent findings or a lack of data prevented definitive conclusions. PMID:24674029

  12. Grading Gradients: Evaluating Evidence for Time-dependent Memory Reorganization in Experimental Animals

    Directory of Open Access Journals (Sweden)

    Katherine G. Akers

    2009-01-01

    Full Text Available In humans, hippocampal damage typically produces temporally graded retrograde amnesia, with relative sparing of remote memories compared to recent memories. This observation led to the idea that as memories age, they are reorganized in a time-dependent manner. Here, we evaluate evidence for time-dependent memory reorganization in animal models. We conclude that, although hippocampal lesions may not always produce temporal gradients under all conditions, studies using alternate experimental approaches consistently support the idea that memories reorganize over time—becoming less dependent on the hippocampus and more dependent on a cortical network. We further speculate on the processes that drive memory reorganization such as sleep, memory reactivation, synaptic plasticity, and neurogenesis.

  13. Evaluation of the Effectiveness of Chemical Dependency Counseling Course Based on Patrick and Partners

    Science.gov (United States)

    Keshavarz, Yousef; Ghaedi, Sina; Rahimi-Kashani, Mansure

    2012-01-01

    Background The twelve step program is one of the programs that are administered for overcoming abuse of drugs. In this study, the effectiveness of chemical dependency counseling course was investigated using a hybrid model. Methods In a survey with sample size of 243, participants were selected using stratified random sampling method. A questionnaire was used for collecting data and one sample t-test employed for data analysis. Findings Chemical dependency counseling courses was effective from the point of view of graduates, chiefs of rehabilitation centers, rescuers and their families and ultimately managers of rebirth society, but it was not effective from the point of view of professors and lecturers. The last group evaluated the effectiveness of chemical dependency counseling courses only in performance level. Conclusion It seems that the chemical dependency counseling courses had appropriate effectiveness and led to change in attitudes, increase awareness, knowledge and experience combination and ultimately increased the efficiency of counseling. PMID:24494132

  14. Dependent failure analysis research for the US NRC Risk Methods Integration and Evaluation Program

    International Nuclear Information System (INIS)

    Bohn, M.P.; Stack, D.W.; Campbell, D.J.; Rooney, J.J.; Rasmuson, D.M.

    1985-01-01

    The Risk Methods Integration and Evaluation Program (RMIEP), which is being performed for the Nuclear Regulatory Commission by Sandia National Laboratories, has the goals of developing new risk assessment methods and integrating the new and existing methods in a uniform procedure for performing an in-depth probabilistic risk assessment (PRA) with consistent levels of analysis for internal, external, and dependent failure scenarios. An important part of RMIEP is the recognition of the crucial importance of dependent common cause failures (CCFs) and the pressing need to develop effective methods for analyzing CCFs as part of a PRA. The NRC-sponsored Integrated Dependent Failure Methodology Program at Sandia is addressing this need. This paper presents a preliminary approach for analyzing CCFs as part of a PRA. A nine-step procedure for efficiently screening and analyzing dependent failure scenarios is presented, and each step is discussed

  15. Load Index Metrics for an Optimized Management of Web Services: A Systematic Evaluation

    Science.gov (United States)

    Souza, Paulo S. L.; Santana, Regina H. C.; Santana, Marcos J.; Zaluska, Ed; Faical, Bruno S.; Estrella, Julio C.

    2013-01-01

    The lack of precision to predict service performance through load indices may lead to wrong decisions regarding the use of web services, compromising service performance and raising platform cost unnecessarily. This paper presents experimental studies to qualify the behaviour of load indices in the web service context. The experiments consider three services that generate controlled and significant server demands, four levels of workload for each service and six distinct execution scenarios. The evaluation considers three relevant perspectives: the capability for representing recent workloads, the capability for predicting near-future performance and finally stability. Eight different load indices were analysed, including the JMX Average Time index (proposed in this paper) specifically designed to address the limitations of the other indices. A systematic approach is applied to evaluate the different load indices, considering a multiple linear regression model based on the stepwise-AIC method. The results show that the load indices studied represent the workload to some extent; however, in contrast to expectations, most of them do not exhibit a coherent correlation with service performance and this can result in stability problems. The JMX Average Time index is an exception, showing a stable behaviour which is tightly-coupled to the service runtime for all executions. Load indices are used to predict the service runtime and therefore their inappropriate use can lead to decisions that will impact negatively on both service performance and execution cost. PMID:23874776

  16. Systematic Evaluation of Promising Clinical Trials-Gene Silencing for the Treatment of Glioblastoma.

    Science.gov (United States)

    Karaarslan, Numan; Yilmaz, Ibrahim; Ozbek, Hanefi; Caliskan, Tezcan; Topuk, Savas; Sirin, Duygu Yasar; Ates, Ozkan

    2018-04-06

    The aim of this study was to systematically investigate the role of artificial small interfering RNA (siRNA) molecules in glioblastoma treatment and to give a detailed overview of the literature concerning studies performed in this field worldwide in the last 31 years. Articles about clinical trials conducted between December 1, 1949 and November 8, 2017, were identified from the Cochrane Collaboration, the Cochrane Library, Ovid MEDLINE, ProQuest, the National Library of Medicine, and PubMed electronic databases, using the terms "post transcriptional gene silencing," "small interfering RNA," "siRNA," and "glioblastoma," either individually or combined (\\"OR\\" and \\"AND"), without language and country restrictions. Articles that met the examination criteria were included in the study. After descriptive statistical evaluation, the results were reported in frequency (%). After scanning 2.752 articles, five articles were found that met the research criteria. Examination of full texts of the five identified articles provided no sufficient evidence for research conducted with regard to the use of gene silencing via siRNAs in glioblastoma treatment. To be able to evaluate the clinical use of siRNAs, there is an urgent need for in-vivo studies and for trials with randomized, controlled, and clinical designs that provide long-term functional outcomes.

  17. Economic evaluation of bone stimulation modalities: A systematic review of the literature.

    Science.gov (United States)

    Button, Melissa L; Sprague, Sheila; Gharsaa, Osama; Latouche, Sandra; Bhandari, Mohit

    2009-04-01

    Various bone stimulation modalities are commonly used in treatment of fresh fractures and nonunions; however, the effectiveness and efficiency of these modalities remain uncertain. A systematic review of trials evaluating the clinical and economical outcomes of ultrasounds, electrical stimulation, and extracorporeal sound waves on fracture healing was conducted. We searched four electronic databases for economic evaluations that assessed bone stimulation modalities using ultrasound therapy, electrical stimulation, or extracorporeal shock waves. In addition, we searched the references and related articles of eligible studies, and a content expert was contacted. Information on the clinical and economical outcomes of patients was independently extracted by reviewers. Fourteen studies met the inclusion criteria; therefore, very limited research was found on the cost associated with treatments and the corresponding outcomes. The data available focus primarily on the efficacy of newly introduced treatment methods for bone growth, but failed to incorporate the costs of implementing such treatments. One economic analysis was identified that assessed different treatment paths using ultrasound. A total cost savings of 24-40% per patient occurred when ultrasound was used for fresh fractures and nonunions (grade C recommendation). The results suggest that the ultrasound is a viable alternative for bone stimulation; however, the impacts of the other modalities are left unknown due to the lack of research available. Methodological limitations leave the overall economic and clinical impact of these modalities uncertain. Large, prospective, randomized controlled trials that include cost-effectiveness analyses are needed to further define the clinical effectiveness and financial burden associated with bone stimulation modalities.

  18. Is the smile line a valid parameter for esthetic evaluation? A systematic literature review.

    Science.gov (United States)

    Passia, Nicole; Blatz, Markus; Strub, Jörg Rudolf

    2011-01-01

    The "smile line" is commonly used as a parameter to evaluate and categorize a person's smile. This systematic literature review assessed the existing evidence on the validity and universal applicability of this parameter. The latter was evaluated based on studies on smile perception by orthodontists, general clinicians, and laypeople. A review of the literature published between October 1973 and January 2010 was conducted with the electronic database Pubmed and the search terms "smile," "smile line," "smile arc," and "smile design." The search yielded 309 articles, of which nine studies were included based on the selection criteria. The selected studies typically correlate the smile line with the position of the upper lip during a smile while, on average, 75 to 100% of the maxillary anterior teeth are exposed. A virtual line that connects the incisal edges of the maxillary anterior teeth commonly follows the upper border of the lower lip. Average and parallel smile lines are most common, influenced by the age and gender of a person. Orthodontists, general clinicians, and laypeople have similar preferences and rate average smile lines as most attractive. The smile line is a valid tool to assess the esthetic appearance of a smile. It can be applied universally as clinicians and laypersons perceive and judge it similarly.

  19. Methods for dependency estimation and system unavailability evaluation based on failure data statistics

    International Nuclear Information System (INIS)

    Azarm, M.A.; Hsu, F.; Martinez-Guridi, G.; Vesely, W.E.

    1993-07-01

    This report introduces a new perspective on the basic concept of dependent failures where the definition of dependency is based on clustering in failure times of similar components. This perspective has two significant implications: first, it relaxes the conventional assumption that dependent failures must be simultaneous and result from a severe shock; second, it allows the analyst to use all the failures in a time continuum to estimate the potential for multiple failures in a window of time (e.g., a test interval), therefore arriving at a more accurate value for system unavailability. In addition, the models developed here provide a method for plant-specific analysis of dependency, reflecting the plant-specific maintenance practices that reduce or increase the contribution of dependent failures to system unavailability. The proposed methodology can be used for screening analysis of failure data to estimate the fraction of dependent failures among the failures. In addition, the proposed method can evaluate the impact of the observed dependency on system unavailability and plant risk. The formulations derived in this report have undergone various levels of validations through computer simulation studies and pilot applications. The pilot applications of these methodologies showed that the contribution of dependent failures of diesel generators in one plant was negligible, while in another plant was quite significant. It also showed that in the plant with significant contribution of dependency to Emergency Power System (EPS) unavailability, the contribution changed with time. Similar findings were reported for the Containment Fan Cooler breakers. Drawing such conclusions about system performance would not have been possible with any other reported dependency methodologies

  20. A Systematic Review of the State of Economic Evaluation for Health Care in India.

    Science.gov (United States)

    Prinja, Shankar; Chauhan, Akashdeep Singh; Angell, Blake; Gupta, Indrani; Jan, Stephen

    2015-12-01

    Economic evaluations are one of the important tools in policy making for rational allocation of resources. Given the very low public investment in the health sector in India, it is critical that resources are used wisely on interventions proven to yield best results. Hence, we undertook this study to assess the extent and quality of evidence for economic evaluation of health-care interventions and programmes in India. A comprehensive search was conducted to search for published full economic evaluations pertaining to India and addressing a health-related intervention or programme. PubMed, Scopus, Embase, ScienceDirect, and York CRD database and websites of important research agencies were identified to search for economic evaluations published from January 1980 to the middle of November 2014. Two researchers independently assessed the quality of the studies based on Drummond and modelling checklist. Out of a total of 5013 articles enlisted after literature search, a total of 104 met the inclusion criteria for this systematic review. The majority of these papers were cost-effectiveness studies (64%), led by a clinician or public-health professional (77%), using decision analysis-based methods (59%), published in an international journal (80%) and addressing communicable diseases (58%). In addition, 42% were funded by an international funding agency or UN/bilateral aid agency, and 30% focussed on pharmaceuticals. The average quality score of these full economic evaluations was 65.1%. The major limitation was the inability to address uncertainties involved in modelling as only about one-third of the studies assessed modelling structural uncertainties (33%), or ran sub-group analyses to account for heterogeneity (36.5%) or analysed methodological uncertainty (32%). The existing literature on economic evaluations in India is inadequate to feed into sound policy making. There is an urgent need to generate awareness within the government of how economic evaluation can

  1. Evaluation Methods for Assessing Users’ Psychological Experiences of Web-Based Psychosocial Interventions: A Systematic Review

    Science.gov (United States)

    Howson, Moira; Ritchie, Linda; Carter, Philip D; Parry, David Tudor; Koziol-McLain, Jane

    2016-01-01

    Background The use of Web-based interventions to deliver mental health and behavior change programs is increasingly popular. They are cost-effective, accessible, and generally effective. Often these interventions concern psychologically sensitive and challenging issues, such as depression or anxiety. The process by which a person receives and experiences therapy is important to understanding therapeutic process and outcomes. While the experience of the patient or client in traditional face-to-face therapy has been evaluated in a number of ways, there appeared to be a gap in the evaluation of patient experiences of therapeutic interventions delivered online. Evaluation of Web-based artifacts has focused either on evaluation of experience from a computer Web-design perspective through usability testing or on evaluation of treatment effectiveness. Neither of these methods focuses on the psychological experience of the person while engaged in the therapeutic process. Objective This study aimed to investigate what methods, if any, have been used to evaluate the in situ psychological experience of users of Web-based self-help psychosocial interventions. Methods A systematic literature review was undertaken of interdisciplinary databases with a focus on health and computer sciences. Studies that met a predetermined search protocol were included. Results Among 21 studies identified that examined psychological experience of the user, only 1 study collected user experience in situ. The most common method of understanding users’ experience was through semistructured interviews conducted posttreatment or questionnaires administrated at the end of an intervention session. The questionnaires were usually based on standardized tools used to assess user experience with traditional face-to-face treatment. Conclusions There is a lack of methods specified in the literature to evaluate the interface between Web-based mental health or behavior change artifacts and users. Main

  2. Evaluation of Technology-Enhanced Learning Programs for Health Care Professionals: Systematic Review.

    Science.gov (United States)

    Nicoll, Pam; MacRury, Sandra; van Woerden, Hugo C; Smyth, Keith

    2018-04-11

    Technology-enhanced learning (TEL) programs are increasingly seen as the way in which education for health care professionals can be transformed, giving access to effective ongoing learning and training even where time or geographical barriers exist. Given the increasing emphasis on this mode of educational support for health care practitioners, it is vital that we can effectively evaluate and measure impact to ensure that TEL programs are effective and fit for purpose. This paper examines the current evidence base for the first time, in relation to the evaluation of TEL programs for health care professionals. We conducted a systematic review of the current literature relating to the evaluation of TEL programs for health care professionals and critically appraised the quality of the studies. This review employed specific search criteria to identify research studies that included evaluation of TEL for health care professionals. The databases searched included Medline Ovid, Cumulative Index of Nursing and Allied Health Literature Plus Advanced, Applied Social Sciences Index and Abstracts, ZETOC, Institute of Electrical and Electronics Engineers Explore Digital Library, Allied and Complementary Medicine, and Education Resources Information Center between January 2006 and January 2017. An additional hand search for relevant articles from reference lists was undertaken. Each of the studies identified was critically appraised for quality using the Crowe Critical Appraisal Tool. This approach produced a percentage total score for each study across specified categories. A proportion of the studies were independently assessed by an additional two reviewers. The review identified 21 studies that met the inclusion criteria. The studies included scored totals across eight categories within a range of 37%-95% and an average score of 68%. Studies that measured TEL using learner satisfaction surveys, or combined pretest and posttest knowledge score testing with learner

  3. Reduction in uptake of PSA tests following decision aids: systematic review of current aids and their evaluations.

    NARCIS (Netherlands)

    Evans, R.; Edwards, A.; Brett, J.; Bradburn, M.; Watson, E.; Austoker, J.; Elwyn, G.

    2005-01-01

    A man's decision to have a prostate-specific antigen (PSA) test should be an informed one. We undertook a systematic review to identify and appraise PSA decision aids and evaluations. We searched 15 electronic databases and hand-searched key journals. We also contacted key authors and organisations.

  4. Development of a systematic method to assess similarity between nanomaterials for human hazard evaluation purposes - lessons learnt.

    NARCIS (Netherlands)

    Vdz Park, Margriet; Catalán, Julia; Ferraz, Natalia; Cabellos, Joan; Vanhauten, Ralph; Vázquez-Campos, Socorro; Janer, Gemma

    2018-01-01

    Within the EU FP-7 GUIDEnano project, a methodology was developed to systematically quantify the similarity between a nanomaterial (NM) that has been tested in toxicity studies and the NM for which risk needs to be evaluated, for the purpose of extrapolating toxicity data between the two materials.

  5. A systematic method for using 3D echocardiography to evaluate tricuspid valve insufficiency in hypoplastic left heart syndrome

    Directory of Open Access Journals (Sweden)

    Christopher Robin Mart

    2014-01-01

    We have proposed a systematic method for evaluating and displaying the TV using 3DE which can provide significant insight into the mechanisms causing TVI in HLHS. This has the potential to improve both the surgical approach to repairing the valve and, ultimately, patient outcomes.

  6. [The methods within the evaluation of disease management programmes in control-group designs using the example of diabetes mellitus - a systematic literature review].

    Science.gov (United States)

    Drabik, A; Sawicki, P T; Müller, D; Passon, A; Stock, S

    2012-08-01

    Disease management programmes (DMPs) were implemented in Germany in 2002. Their evaluation is required by law. Beyond the mandatory evaluation, a growing number of published studies evaluate the DMP for diabetes mellitus type 2 in a control-group design. As patients opt into the programme on a voluntary basis it is necessary to adjust the inherent selection bias between groups. The aim of this study is to review published studies which evaluate the diabetes DMP using a control-group design with respect to the methods used. A systematic literature review of electronic databases (PUBMED, Cochrane Library, EMBASE, MEDPILOT) and a hand search of reference lists of the relevant publications was conducted to identify studies evaluating the DMP diabetes mellitus in a control-group design. 8 studies were included in the systematic literature review. 4 studies gathered retrospective claims data from sickness funds, one from physician's records, one study used prospective data from ambulatory care, and 2 studies were based on one patient survey. Methods used for adjustment of selection bias included exact matching, matching using propensity score methods, age-adjusted and sex-separated analysis, and adjustment in a regression model/analysis of covariance. One study did not apply adjustment methods. The intervention period ranged from 1 day to 4 years. Considered outcomes of studies (surrogate parameter, diabetes complications, mortality, quality of life, and claim data) depended on the database. In the evaluation of the DMP diabetes mellitus based on a control-group design neither the database nor the methods used for selection bias adjustment were consistent in the available studies. Effectiveness of DMPs cannot be judged based on this review due to heterogeneity of study designs. To allow for a comprehensive programme evaluation standardised minimum requirements for the evaluation of DMPs in the control group design are required. © Georg Thieme Verlag KG Stuttgart · New

  7. [Economic evaluation on breast cancer screening in mainland China: a systematic review].

    Science.gov (United States)

    Wang, L; Shi, J F; Huang, H Y; Zhu, J; Li, J; Fang, Y; Dai, M

    2016-12-10

    Objective: To gather available evidence related to the economic evaluation on breast cancer screening in mainland China and to provide reference for further research. Methods: A systematic review was conducted to identify articles in PubMed and three Chinese databases (CNKI, Wanfang and VIP) during 1995-2015. Data related to descriptive characteristics, rates on participation and detection for population-based studies, methods for model-based studies, types of economic evaluation and results, were extracted. A Consolidated Health Economic Evaluation Reporting Standards (CHEERS) was used to assess the reporting quality of included studies. Results: Of the 356 records searched in the databases, 13 studies (all published between 2012 and 2015) were included in the current paper involving 11 population-based studies and 3 model-based evaluations (1 study using both methods). Age of the participants who started to be engaged in the screening program ranged from 18 to 45 years old, but terminated at the age of 59 years or older. The screening modalities included single-used clinical breast examination, mammography and ultrasound or combined applications. Study persepectives were described in 7 studies, with 5 from the healthcare providers, and 2 from societal angles. Only 5 studies discounted cost or effectiveness. Out of 11 papers, 9 showed the results on cost-effectiveness analysis (CEA) that reporting the cost per breast cancer detection, with median as 145.0 thousand Chinese Yuan (CNY), ranging from 49.7 thousand to 2 293.0 thousand CNY. From 4 papers with results of cost-utility analysis (CUA), the cost per quality adjusted life year (QALY) gained or cost per disability adjusted life year (DALY) averted, were evaluated. The incremental cost-effectiveness ratio (ICER) was from 2.9 thousand to 270.7 thousand CNY (GDP per capita of China was CNY 49.3 thousand in 2015). In 13 studies, the quality of reporting varied, with an average score of 14.5 (range: 9.5-21.0). In

  8. Dependability evaluation of computing systems - physical faults, design faults, malicious faults

    International Nuclear Information System (INIS)

    Kaaniche, Mohamed

    1999-01-01

    The research summarized in this report focuses on the dependability of computer systems. It addresses several complementary, theoretical as well as experimental, issues that are grouped into four topics. The first topic concerns the definition of efficient methods that aim to assist the users in the construction and validation of complex dependability analysis and evaluation models. The second topic deals with the modeling of reliability and availability growth that mainly result from the progressive removal of design faults. A method is also defined to support the application of software reliability evaluation studies in an industrial context. The third topic deals with the development and experimentation of a new approach for the quantitative evaluation of operational security. This approach aims to assist the system administrators in the monitoring of operational security, when modifications, that are likely to introduce new vulnerabilities, occur in the system configuration, the applications, the user behavior, etc. Finally, the fourth topic addresses: a) the definition of a development model focused at the production of dependable systems, and b) the development of assessment criteria to obtain justified confidence that a system will achieve, during its operation and up to its decommissioning, its dependability objectives. (author) [fr

  9. Review and evaluation of online tobacco dependence treatment training programs for health care practitioners.

    Science.gov (United States)

    Selby, Peter; Goncharenko, Karina; Barker, Megan; Fahim, Myra; Timothy, Valerie; Dragonetti, Rosa; Kemper, Katherine; Herie, Marilyn; Hays, J Taylor

    2015-04-17

    Training health care professionals is associated with increased capacity to deliver evidence-based smoking cessation interventions and increased quit rates among their patients. Online training programs hold promise to provide training but questions remain regarding the quality and usability of available programs. The aim was to assess the quality of English-language online courses in tobacco dependence treatment using a validated instrument. An environmental scan was conducted using the Google search engine to identify available online tobacco dependence treatment courses. The identified courses were then evaluated using the Peer Review Rubric for Online Learning, which was selected based on its ability to evaluate instructional design. It also has clear and concise criteria descriptions to ensure uniformity of evaluations by trained experts. A total of 39 courses were identified, of which 24 unique courses were assessed based on their accessibility and functionality during the period of evaluation. Overall, the course ratings indicated that 17 of 24 courses evaluated failed to meet minimal quality standards and none of the courses evaluated could be ranked as superior. However, many excelled in providing effective navigation, course rationale, and content. Many were weak in the use of instructional design elements, such as teaching effectiveness, learning strategies, instructor's role, and assessment and evaluation. Evaluation results and suggestions for improvement were shared with course administrators. Based on the courses evaluated in this review, course developers are encouraged to employ best practices in instructional design, such as cohesiveness of material, linearity of design, practice exercises, problem solving, and ongoing evaluation to improve existing courses and in the design of new online learning opportunities.

  10. Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Neily Zakiyah

    Full Text Available A significant number of women in low and middle income countries (L-MICs who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research.A systematic review was performed in several electronic databases i.e Medline (Pubmed, Embase, Popline, The National Bureau of Economic Research (NBER, EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS statement.From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors.Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary

  11. Performance of ultraviolet photocatalytic oxidation for indoor air applications: Systematic experimental evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Zhong, Lexuan [Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, Quebec H3G 1M8 (Canada); Haghighat, Fariborz, E-mail: fariborz.haghighat@concordia.ca [Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, Quebec H3G 1M8 (Canada); Lee, Chang-Seo [Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, Quebec H3G 1M8 (Canada); Lakdawala, Ness [DECTRON International Inc., Montreal, Quebec (Canada)

    2013-10-15

    Highlights: • An innovative experimental set-up was designed and constructed for testing UV-PCO. • Test methodologies were developed to examine UV-PCO air cleaners for VOCs removal. • VOCs type, inlet concentration, flow rate, irradiance, and RH have influence on PCO. • Gas-phase ozonation with a variety of compounds was examined in a duct system. • Formation of by-products generated from incomplete conversion was investigated. -- Abstract: Photocatalytic oxidation (PCO) is a promising technology that has potential to be applied in mechanically ventilated buildings to improve indoor air quality (IAQ). However, the major research studies were done in bench-top scale reactors under ideal reaction conditions. In addition, no study has been carried out on the investigation of the ozonation and photolysis effect using a pilot duct system. The objective of this study is the development of methodologies to evaluate the performance of PCO systems. A systematic parametric evaluation of the effects of various kinetic parameters, such as compound's type, inlet concentration, airflow rate, light intensity, and relative humidity, was conducted, and new interpretations were provided from a fundamental analysis. In addition, the photolysis effect under vacuum ultraviolet (VUV) irradiation for a variety of volatile organic compounds (VOCs) was examined for the first time in a pilot duct system. The performance comparison of ultraviolet C (UVC)-PCO and VUV-PCO was also discussed due to the presence of ozone. Moreover, the formation of by-products generated with or without ozone generation was fully compared to evaluate the PCO technology.

  12. Economic evaluations of Haemophilus influenzae type b (Hib) vaccine: a systematic review.

    Science.gov (United States)

    Chongmelaxme, Bunchai; Hammanee, Maythika; Phooaphirak, Wariya; Kotirum, Surachai; Hutubessy, Raymond; Chaiyakunapruk, Nathorn

    2017-10-01

    The World Health Organization (WHO) recommends the use of Haemophilus influenzae type b (Hib) conjugate vaccines, but China and Thailand have not used Hib vaccination in their national immunization programs. This systematic review aimed to update published economic evaluations of Hib vaccinations and to determine factors that potentially affected their cost-effectiveness. Searches were performed from the inception until December 2015 using 13 databases: CAB direct; CEA registry; EconLit; EMBASE; E-library; NHSEED; PAHO; POPLINE; PubMed; Redalyc project; RePEc; SciELO; and WHOLIS. Reference lists of relevant studies and grey literature were also searched. Full economic evaluations of Hib vaccination with results of costs and outcomes were included. The WHO checklist was used to evaluate the quality of the included studies. Data from eligible studies were extracted using a standardized data collection form. Out of 830 articles, 27 were included. Almost half of the studies (12/27) were conducted in high-income countries. Twelve studies (12/27) investigated the Hib vaccine as an addition to the existing vaccination program. Most studies (17/27) examined a 3-dose schedule of Hib vaccine. Nineteen studies (19/27) reported the model used, where all were decision tree models. Most of the studies (23/27) demonstrated an economic value of Hib vaccination programs, key influential parameters being incidence rates of Hib disease and vaccine price. Hib vaccination programs are mostly found to be cost-effective across geographic regions and country income levels, and Hib vaccination is recommended for inclusion into all national immunization programs. The findings are expected to support policy-makers for making decisions on allocating limited resources of the Hib vaccination program effectively.

  13. Performance of ultraviolet photocatalytic oxidation for indoor air applications: Systematic experimental evaluation

    International Nuclear Information System (INIS)

    Zhong, Lexuan; Haghighat, Fariborz; Lee, Chang-Seo; Lakdawala, Ness

    2013-01-01

    Highlights: • An innovative experimental set-up was designed and constructed for testing UV-PCO. • Test methodologies were developed to examine UV-PCO air cleaners for VOCs removal. • VOCs type, inlet concentration, flow rate, irradiance, and RH have influence on PCO. • Gas-phase ozonation with a variety of compounds was examined in a duct system. • Formation of by-products generated from incomplete conversion was investigated. -- Abstract: Photocatalytic oxidation (PCO) is a promising technology that has potential to be applied in mechanically ventilated buildings to improve indoor air quality (IAQ). However, the major research studies were done in bench-top scale reactors under ideal reaction conditions. In addition, no study has been carried out on the investigation of the ozonation and photolysis effect using a pilot duct system. The objective of this study is the development of methodologies to evaluate the performance of PCO systems. A systematic parametric evaluation of the effects of various kinetic parameters, such as compound's type, inlet concentration, airflow rate, light intensity, and relative humidity, was conducted, and new interpretations were provided from a fundamental analysis. In addition, the photolysis effect under vacuum ultraviolet (VUV) irradiation for a variety of volatile organic compounds (VOCs) was examined for the first time in a pilot duct system. The performance comparison of ultraviolet C (UVC)-PCO and VUV-PCO was also discussed due to the presence of ozone. Moreover, the formation of by-products generated with or without ozone generation was fully compared to evaluate the PCO technology

  14. Tools for evaluation of restriction on auditory participation: systematic review of the literature.

    Science.gov (United States)

    Souza, Valquíria Conceição; Lemos, Stela Maris Aguiar

    2015-01-01

    To systematically review studies that used questionnaires for the evaluation of restriction on auditory participation in adults and the elderly. Studies from the last five years were selected through a bibliographic collection of data in national and international journals in the following electronic databases: ISI Web of Science and Virtual Health Library - BIREME, which includes the LILACS and MEDLINE databases. Studies available fully; published in Portuguese, English, or Spanish; whose participants were adults and/or the elderly and that used questionnaires for the evaluation of restriction on auditory participation. Initially, the studies were selected based on the reading of titles and abstracts. Then, the articles were fully and the information was included in the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Three-hundred seventy studies were found in the researched databases; 14 of these studies were excluded because they were found in more than one database. The titles and abstracts of 356 articles were analyzed; 40 of them were selected for full reading, of which 26 articles were finally selected. In the present review, nine instruments were found for the evaluation of restriction on auditory participation. The most used questionnaires for the assessment of the restriction on auditory participation were the Hearing Handicap Inventory for the Elderly (HHIE), Hearing Handicap Inventory for Adults (HHIA), and Hearing Handicap Inventory for the Elderly - Screening (HHIE-S). The use of restriction on auditory participation questionnaires can assist in validating decisions in audiology practices and be useful in the fitting of hearing aids and results of aural rehabilitation.

  15. Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review.

    Science.gov (United States)

    Zakiyah, Neily; van Asselt, Antoinette D I; Roijmans, Frank; Postma, Maarten J

    2016-01-01

    A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research. A systematic review was performed in several electronic databases i.e Medline (Pubmed), Embase, Popline, The National Bureau of Economic Research (NBER), EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors. Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary to generate

  16. Systematic Review of Health Economic Evaluations of Diagnostic Tests in Brazil: How accurate are the results?

    Science.gov (United States)

    Oliveira, Maria Regina Fernandes; Leandro, Roseli; Decimoni, Tassia Cristina; Rozman, Luciana Martins; Novaes, Hillegonda Maria Dutilh; De Soárez, Patrícia Coelho

    2017-08-01

    The aim of this study is to identify and characterize the health economic evaluations (HEEs) of diagnostic tests conducted in Brazil, in terms of their adherence to international guidelines for reporting economic studies and specific questions in test accuracy reports. We systematically searched multiple databases, selecting partial and full HEEs of diagnostic tests, published between 1980 and 2013. Two independent reviewers screened articles for relevance and extracted the data. We performed a qualitative narrative synthesis. Forty-three articles were reviewed. The most frequently studied diagnostic tests were laboratory tests (37.2%) and imaging tests (32.6%). Most were non-invasive tests (51.2%) and were performed in the adult population (48.8%). The intended purposes of the technologies evaluated were mostly diagnostic (69.8%), but diagnosis and treatment and screening, diagnosis, and treatment accounted for 25.6% and 4.7%, respectively. Of the reviewed studies, 12.5% described the methods used to estimate the quantities of resources, 33.3% reported the discount rate applied, and 29.2% listed the type of sensitivity analysis performed. Among the 12 cost-effectiveness analyses, only two studies (17%) referred to the application of formal methods to check the quality of the accuracy studies that provided support for the economic model. The existing Brazilian literature on the HEEs of diagnostic tests exhibited reasonably good performance. However, the following points still require improvement: 1) the methods used to estimate resource quantities and unit costs, 2) the discount rate, 3) descriptions of sensitivity analysis methods, 4) reporting of conflicts of interest, 5) evaluations of the quality of the accuracy studies considered in the cost-effectiveness models, and 6) the incorporation of accuracy measures into sensitivity analyses.

  17. Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.

    Science.gov (United States)

    Pérez Velasco, Román; Praditsitthikorn, Naiyana; Wichmann, Kamonthip; Mohara, Adun; Kotirum, Surachai; Tantivess, Sripen; Vallenas, Constanza; Harmanci, Hande; Teerawattananon, Yot

    2012-01-01

    Although public health guidelines have implications for resource allocation, these issues were not explicitly considered in previous WHO pandemic preparedness and response guidance. In order to ensure a thorough and informed revision of this guidance following the H1N1 2009 pandemic, a systematic review of published and unpublished economic evaluations of preparedness strategies and interventions against influenza pandemics was conducted. The search was performed in September 2011 using 10 electronic databases, 2 internet search engines, reference list screening, cited reference searching, and direct communication with relevant authors. Full and partial economic evaluations considering both costs and outcomes were included. Conversely, reviews, editorials, and studies on economic impact or complications were excluded. Studies were selected by 2 independent reviewers. 44 studies were included. Although most complied with the cost effectiveness guidelines, the quality of evidence was limited. However, the data sources used were of higher quality in economic evaluations conducted after the 2009 H1N1 pandemic. Vaccination and drug regimens were varied. Pharmaceutical plus non-pharmaceutical interventions are relatively cost effective in comparison to vaccines and/or antivirals alone. Pharmaceutical interventions vary from cost saving to high cost effectiveness ratios. According to ceiling thresholds (Gross National Income per capita), the reduction of non-essential contacts and the use of pharmaceutical prophylaxis plus the closure of schools are amongst the cost effective strategies for all countries. However, quarantine for household contacts is not cost effective even for low and middle income countries. The available evidence is generally inconclusive regarding the cost effectiveness of preparedness strategies and interventions against influenza pandemics. Studies on their effectiveness and cost effectiveness should be readily implemented in forthcoming events that

  18. Evaluation of factors that affect hip moment impulse during gait: A systematic review.

    Science.gov (United States)

    Inai, Takuma; Takabayashi, Tomoya; Edama, Mutsuaki; Kubo, Masayoshi

    2018-03-01

    Decreasing the daily cumulative hip moments in the frontal and sagittal planes may lower the risk of hip osteoarthritis. Therefore, it may be important to evaluate factors that affect hip moment impulse during gait. It is unclear what factors affect hip moment impulse during gait. This systematic review aimed to evaluate different factors that affect hip moment impulse during gait in healthy adults and patients with hip osteoarthritis. Four databases (Scopus, ScienceDirect, PubMed, and PEDro) were searched up to August 2017 to identify studies that examined hip moment impulse during gait. Data extracted for analysis included the sample size, age, height, body mass, type of intervention, and main findings. After screening, 10 of the 975 studies identified were included in our analysis. Several factors, including a rocker bottom shoe, FitFlop™ sandals, ankle push-off, posture, stride length, body-weight unloading, a rollator, walking poles, and a knee brace, were reviewed. The main findings were as follows: increasing ankle push-off decreased both the hip flexion and extension moment impulses; body-weight unloading decreased both the hip extension and adduction moment impulses; the FitFlop™ sandal increased the sum of the hip flexion and extension moment impulses; long strides increased the hip extension moment impulse; and the use of a knee brace increased hip flexion moment impulse. Of note, none of the eligible studies included patients with hip osteoarthritis. The hip moment impulses can be modified by person-specific factors (ankle push-off and long strides) and external factors (body-weight unloading and use of the FitFlop™ sandals and a knee brace). Effects on the progression of hip osteoarthritis remain to be evaluated. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Evaluating Simulation in Training for Arthroscopic Knee Surgery: A Systematic Review of the Literature.

    Science.gov (United States)

    Hetaimish, Bandar; Elbadawi, Hussein; Ayeni, Olufemi R

    2016-06-01

    To evaluate the reported outcomes for measuring the effectiveness of simulation during knee arthroscopy training and determine the consistency of reporting and validation of simulation used in knee arthroscopy training. Four databases (MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials) were screened for studies involving knee arthroscopy simulation training. Inclusion and exclusion criteria were applied to the searched studies, and a quality assessment was completed for included studies. The reviewers searched the references list in each of the eligible studies to identify other relevant studies that was not captured by our search strategy. We identified 13 eligible studies. The mean number of participants per study was 24 (range: 9 to 42 participants). The 3 most commonly reported surgical skills were the mean time to perform the task (100%), the visualization and probing tasks (77%), and the number of cartilage collisions with measurement of the surgical force (46%). The most commonly described measurement instruments included the Simulation Built-In Scoring System (54%), motion analysis system (23%), and Basic Arthroscopic Knee Skill Scoring System global rating scale (15%). The most frequently reported type of validity for the simulator was construct validity (54%) and concurrent validity (31%). Moreover, construct validity (69%) and concurrent validity (54%) were the most commonly reported type of validity for the measurement instrument. There is significant variation in reported learning outcomes and measurement instruments for evaluating the effectiveness of knee arthroscopic simulation-based education. Despite this, time to perform a task was the most commonly reported skill-evaluating outcome of simulation. The included studies in this review were of variable strength in terms of their evidence and methodologic quality. This study highlights the need for consistent outcome reporting after arthroscopic simulation training. Level IV

  20. Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.

    Directory of Open Access Journals (Sweden)

    Román Pérez Velasco

    Full Text Available BACKGROUND: Although public health guidelines have implications for resource allocation, these issues were not explicitly considered in previous WHO pandemic preparedness and response guidance. In order to ensure a thorough and informed revision of this guidance following the H1N1 2009 pandemic, a systematic review of published and unpublished economic evaluations of preparedness strategies and interventions against influenza pandemics was conducted. METHODS: The search was performed in September 2011 using 10 electronic databases, 2 internet search engines, reference list screening, cited reference searching, and direct communication with relevant authors. Full and partial economic evaluations considering both costs and outcomes were included. Conversely, reviews, editorials, and studies on economic impact or complications were excluded. Studies were selected by 2 independent reviewers. RESULTS: 44 studies were included. Although most complied with the cost effectiveness guidelines, the quality of evidence was limited. However, the data sources used were of higher quality in economic evaluations conducted after the 2009 H1N1 pandemic. Vaccination and drug regimens were varied. Pharmaceutical plus non-pharmaceutical interventions are relatively cost effective in comparison to vaccines and/or antivirals alone. Pharmaceutical interventions vary from cost saving to high cost effectiveness ratios. According to ceiling thresholds (Gross National Income per capita, the reduction of non-essential contacts and the use of pharmaceutical prophylaxis plus the closure of schools are amongst the cost effective strategies for all countries. However, quarantine for household contacts is not cost effective even for low and middle income countries. CONCLUSION: The available evidence is generally inconclusive regarding the cost effectiveness of preparedness strategies and interventions against influenza pandemics. Studies on their effectiveness and cost

  1. A Systematic Literature Review of Economic Evaluations of Antibiotic Treatments for Clostridium difficile Infection.

    Science.gov (United States)

    Burton, Hannah E; Mitchell, Stephen A; Watt, Maureen

    2017-11-01

    Clostridium difficile infection (CDI) is associated with high management costs, particularly in recurrent cases. Fidaxomicin treatment results in lower recurrence rates than vancomycin and metronidazole, but has higher acquisition costs in Europe and the USA. This systematic literature review summarises economic evaluations (EEs) of fidaxomicin, vancomycin and metronidazole for treatment of CDI. Electronic databases (MEDLINE ® , Embase, Cochrane Library) and conference proceedings (ISPOR, ECCMID, ICAAC and IDWeek) were searched for publications reporting EEs of fidaxomicin, vancomycin and/or metronidazole in the treatment of CDI. Reference bibliographies of identified manuscripts were also reviewed. Cost-effectiveness was evaluated according to the overall population of patients with CDI, as well as in subgroups with severe CDI or recurrent CDI, or those at higher risk of recurrence or mortality. Overall, 27 relevant EEs, conducted from the perspective of 12 different countries, were identified. Fidaxomicin was cost-effective versus vancomycin and/or metronidazole in 14 of 24 EEs (58.3%), vancomycin was cost-effective versus fidaxomicin and/or metronidazole in five of 27 EEs (18.5%) and metronidazole was cost-effective versus fidaxomicin and/or vancomycin in two of 13 EEs (15.4%). Fidaxomicin was cost-effective versus vancomycin in most of the EEs evaluating specific patient subgroups. Key cost-effectiveness drivers were cure rate, recurrence rate, time horizon, drug costs and length and cost of hospitalisation. In most EEs, fidaxomicin was demonstrated to be cost-effective versus metronidazole and vancomycin in patients with CDI. These results have relevance to clinical practice, given the high budgetary impact of managing CDI and increasing restrictions on healthcare budgets. This analysis was initiated and funded by Astellas Pharma Inc.

  2. Applying the Analytic Hierarchy Process in healthcare research: A systematic literature review and evaluation of reporting.

    Science.gov (United States)

    Schmidt, Katharina; Aumann, Ines; Hollander, Ines; Damm, Kathrin; von der Schulenburg, J-Matthias Graf

    2015-12-24

    The Analytic Hierarchy Process (AHP), developed by Saaty in the late 1970s, is one of the methods for multi-criteria decision making. The AHP disaggregates a complex decision problem into different hierarchical levels. The weight for each criterion and alternative are judged in pairwise comparisons and priorities are calculated by the Eigenvector method. The slowly increasing application of the AHP was the motivation for this study to explore the current state of its methodology in the healthcare context. A systematic literature review was conducted by searching the Pubmed and Web of Science databases for articles with the following keywords in their titles or abstracts: "Analytic Hierarchy Process," "Analytical Hierarchy Process," "multi-criteria decision analysis," "multiple criteria decision," "stated preference," and "pairwise comparison." In addition, we developed reporting criteria to indicate whether the authors reported important aspects and evaluated the resulting studies' reporting. The systematic review resulted in 121 articles. The number of studies applying AHP has increased since 2005. Most studies were from Asia (almost 30%), followed by the US (25.6%). On average, the studies used 19.64 criteria throughout their hierarchical levels. Furthermore, we restricted a detailed analysis to those articles published within the last 5 years (n = 69). The mean of participants in these studies were 109, whereas we identified major differences in how the surveys were conducted. The evaluation of reporting showed that the mean of reported elements was about 6.75 out of 10. Thus, 12 out of 69 studies reported less than half of the criteria. The AHP has been applied inconsistently in healthcare research. A minority of studies described all the relevant aspects. Thus, the statements in this review may be biased, as they are restricted to the information available in the papers. Hence, further research is required to discover who should be interviewed and how, how

  3. Systematic review on the evaluation criteria of orphan medicines in Central and Eastern European countries.

    Science.gov (United States)

    Zelei, Tamás; Molnár, Mária J; Szegedi, Márta; Kaló, Zoltán

    2016-06-04

    In case of orphan drugs applicability of the standard health technology assessment (HTA) process is limited due to scarcity of good clinical and health economic evidence. Financing these premium priced drugs is more controversial in the Central and Eastern European (CEE) region where the public funding resources are more restricted, and health economic justification should be an even more important aspect of policy decisions than in higher income European countries. To explore and summarize the recent scientific evidence on value drivers related to the health technology assessment of ODs with a special focus on the perspective of third party payers in CEE countries. The review aims to list all potentially relevant value drivers in the reimbursement process of orphan drugs. A systematic literature review was performed; PubMed and Scopus databases were systematically searched for relevant publications until April 2015. Extracted data were summarized along key HTA elements. From the 2664 identified publications, 87 contained relevant information on the evaluation criteria of orphan drugs, but only 5 had direct information from the CEE region. The presentation of good clinical evidence seems to play a key role especially since this should be the basis of cost-effectiveness analyses, which have more importance in resource-constrained economies. Due to external price referencing of pharmaceuticals, the relative budget impact of orphan drugs is expected to be higher in CEE than in Western European (WE) countries unless accessibility of patients remains more limited in poorer European regions. Equity principles based on disease prevalence and non-availability of alternative treatment options may increase the price premium, however, societies must have some control on prices and a rationale based on multiple criteria in reimbursement decisions. The evaluation of orphan medicines should include multiple criteria to appropriately measure the clinical added value of orphan

  4. Conflicts of Interest in Medicine. A Systematic Review of Published and Scientifically evaluated Curricula

    Directory of Open Access Journals (Sweden)

    Weißkircher, Janosch

    2017-08-01

    Full Text Available Objective: Conflicts of interests resulting from interactions with pharmaceutical companies are pervasive in medicine and can result in an undue influence on physicians’ decision-making. The objective of this systematic review is to analyze published and scientifically evaluated curricula for medical students and residents regarding such conflicts of interest. We begin by describing the covered topics and teaching methods; afterwards we analyze the quality of the curricula using the published data on their evaluations and comparing the content with content recommended for such curricula.Methods: We searched Pubmed, PsycInfo, EMBASE, OECD, WISO, SOWI and googlescholar up to and including the 5th of September 2016. Publications describing curricula for residents or medical students on the topic of conflicts of interest in medicine and evaluating them for their effects on the participants’ learning were included. We analyzed the covered topics and the teaching methods used and compared them with recommendations by the American Medical Students’ Association (AMSA and Health Action International (HAI. Results: The literature search resulted in 20 publications that fulfilled our search criteria. In five trials, a control group was used, in no trial the participants were randomized to intervention or control group. 16/20 published curricula primarily covered marketing strategies by pharmaceutical companies, especially the interaction with pharmaceutical sales representatives (PSRs. Most curricula only covered a limited number of topics recommended by AMSA/HAI. The most frequent teaching method was a group discussion, which was used in 18/20 curricula; all curricula used at least one interactive teaching method. The evaluation of the curricula was heterogeneous in results as well as design. Some publications described a change of attitudes toward a stronger skepticism regarding interactions with pharmaceutical companies. Four publications

  5. Health economic evaluations of medical devices in the People's Republic of China: A systematic literature review.

    Science.gov (United States)

    Zhang, Rongrong; Modaresi, Farhang; Borisenko, Oleg

    2015-01-01

    The objective of this study is to identify and review the methodological quality of health economic evaluations of medical devices performed in the People's Republic of China. To our knowledge, no such investigations have been performed to date. A systematic literature review involving searches of Medline, Medline In-Process, the National Health Service Economic Evaluation Database, the Cost-Effectiveness Analysis Registry of the Tufts Medical Center, and the Wanfang Database was performed. The search spanned the period from 1990 to 2013. Studies on health economic evaluations of medical devices, in-vitro diagnostics, procedures, and the use of medical devices in Chinese health care settings were included. Full-text articles and conference abstracts in English and Chinese were included. Fifty-seven publications were included, 26 (46%) of which were in English and 31 (54%) of which were in Chinese. The included publications covered a wide range of clinical areas, such as surgery (n=23, 40%), screening (n=9, 16%), imaging use (n=6, 11%), kidney intervention (n=4, 7%), and nine other technological areas. Most of the studies (n=31, 54%) were cost analyses. Among the others, 13 (50%) studies used modeling, and another 13 (50%) were within-trial evaluations. Among studies that used modeling, eleven (85%) conducted sensitivity analyses, six of which had one-way sensitivity analysis, whereas one conducted both one-way and two-way sensitivity analyses; four of these eleven modeling-based analyses included probabilistic sensitivity analyses. The incremental cost-effectiveness ratio was reported in ten (18%) studies, eight of which were screening studies. The remaining two modeling studies were in areas of imaging and oncology. This study indicates that there are major limitations and deficiencies in the health economic evaluations on medical devices performed in the People's Republic of China. Further efforts are required from different stakeholders - academic, governmental

  6. Conflicts of Interest in Medicine. A Systematic Review of Published and Scientifically evaluated Curricula.

    Science.gov (United States)

    Weißkircher, Janosch; Koch, Cora; Dreimüller, Nadine; Lieb, Klaus

    2017-01-01

    Objective: Conflicts of interests resulting from interactions with pharmaceutical companies are pervasive in medicine and can result in an undue influence on physicians' decision-making. The objective of this systematic review is to analyze published and scientifically evaluated curricula for medical students and residents regarding such conflicts of interest. We begin by describing the covered topics and teaching methods; afterwards we analyze the quality of the curricula using the published data on their evaluations and comparing the content with content recommended for such curricula. Methods: We searched Pubmed, PsycInfo, EMBASE, OECD, WISO, SOWI and googlescholar up to and including the 5th of September 2016. Publications describing curricula for residents or medical students on the topic of conflicts of interest in medicine and evaluating them for their effects on the participants' learning were included. We analyzed the covered topics and the teaching methods used and compared them with recommendations by the American Medical Students' Association (AMSA) and Health Action International (HAI). Results: The literature search resulted in 20 publications that fulfilled our search criteria. In five trials, a control group was used, in no trial the participants were randomized to intervention or control group. 16/20 published curricula primarily covered marketing strategies by pharmaceutical companies, especially the interaction with pharmaceutical sales representatives (PSRs). Most curricula only covered a limited number of topics recommended by AMSA/HAI. The most frequent teaching method was a group discussion, which was used in 18/20 curricula; all curricula used at least one interactive teaching method. The evaluation of the curricula was heterogeneous in results as well as design. Some publications described a change of attitudes toward a stronger skepticism regarding interactions with pharmaceutical companies. Four publications described improved knowledge

  7. [A systematic evaluation of application of the web-based cancer database].

    Science.gov (United States)

    Huang, Tingting; Liu, Jialin; Li, Yong; Zhang, Rui

    2013-10-01

    In order to support the theory and practice of the web-based cancer database development in China, we applied a systematic evaluation to assess the development condition of the web-based cancer databases at home and abroad. We performed computer-based retrieval of the Ovid-MEDLINE, Springerlink, EBSCOhost, Wiley Online Library and CNKI databases, the papers of which were published between Jan. 1995 and Dec. 2011, and retrieved the references of these papers by hand. We selected qualified papers according to the pre-established inclusion and exclusion criteria, and carried out information extraction and analysis of the papers. Eventually, searching the online database, we obtained 1244 papers, and checking the reference lists, we found other 19 articles. Thirty-one articles met the inclusion and exclusion criteria and we extracted the proofs and assessed them. Analyzing these evidences showed that the U.S.A. counted for 26% in the first place. Thirty-nine percent of these web-based cancer databases are comprehensive cancer databases. As for single cancer databases, breast cancer and prostatic cancer are on the top, both counting for 10% respectively. Thirty-two percent of the cancer database are associated with cancer gene information. For the technical applications, MySQL and PHP applied most widely, nearly 23% each.

  8. Economic Evaluation of Implant-Supported Overdentures in Edentulous Patients: A Systematic Review.

    Science.gov (United States)

    Zhang, Qi; Jin, Xin; Yu, Mengliu; Ou, Guoming; Matsui, Hiroyuki; Liang, Xing; Sasaki, Keiichi

    Edentulous patients benefit significantly from implant-supported overdenture prostheses. The purpose of this systematic review was to evaluate the cost-effectiveness of implant-supported overdentures (IODs) for edentulous patients. The search was limited to studies written in English and included an electronic and manual search through MEDLINE (Ovid, 1946 to November 2015), Embase (Ovid, 1966 to November 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (to November 2015), and PubMed (to November 2015). Two investigators extracted the data and assessed the studies independently. No meta-analysis was conducted due to the high heterogeneity within the literature. Of the initial 583 selected articles, 10 studies involving 802 participants were included. Of these, 6 studies had a high risk of bias and the rest had an unclear risk of bias. Implant-supported prostheses were more cost-effective when compared to conventional dentures and fixed implant-supported prostheses. Overdentures supported by two implants and magnet attachment were reported as cost-effective. Implant-supported overdentures are a cost-effective treatment for edentulous patients. More clinical studies with appropriate scientific vigor are required to further assess the cost-effectiveness of implant-supported overdentures.

  9. Evaluating Chagas disease progression and cure through blood-derived biomarkers: a systematic review.

    Science.gov (United States)

    Requena-Méndez, Ana; López, Manuel Carlos; Angheben, Andrea; Izquierdo, Luis; Ribeiro, Isabela; Pinazo, Maria-Jesús; Gascon, Joaquim; Muñoz, José

    2013-09-01

    This article reviews the usefulness of various types of blood-derived biomarkers that are currently being studied to predict the progression of Chagas disease in patients with the indeterminate form, to assess the efficacy of antiparasitic drugs and to identify early cardiac and gastrointestinal damage. The authors used a search strategy based on MEDLINE, Cochrane Library Register for systematic review, EmBase, Global Health and LILACS databases. Out of 1716 screened articles, only 166 articles were eligible for final inclusion. The authors classified the biomarkers according to their biochemical structure and primary biological activity in four groups: i) markers of inflammation and cellular injury, ii) metabolic biomakers, iii) prothrombotic biomarkers and iv) markers derived from specific antigens of the parasite. Several potential biomarkers might have clinical potential for the detection of early cardiopathy. Such capacity is imperative in order to detect high-risk patients who require intensive monitoring and earlier therapy. Prospective studies with longer follow-ups are needed for the appraisal of biomarkers assessing clinical or microbiological cure after therapy. At the same time, studies evaluating more than one biomarker are useful to compare the efficacy among them given the lack of a recognized gold standard.

  10. A systematic review and economic evaluation of diagnostic strategies for Lynch syndrome.

    Science.gov (United States)

    Snowsill, Tristan; Huxley, Nicola; Hoyle, Martin; Jones-Hughes, Tracey; Coelho, Helen; Cooper, Chris; Frayling, Ian; Hyde, Chris

    2014-09-01

    Lynch syndrome (LS) is an inherited autosomal dominant disorder characterised by an increased risk of colorectal cancer (CRC) and other cancers, and caused by mutations in the deoxyribonucleic acid (DNA) mismatch repair genes. To evaluate the accuracy and cost-effectiveness of strategies to identify LS in newly diagnosed early-onset CRC patients (aged strategies for individuals in whom LS is identified. Systematic reviews were conducted of the test accuracy of microsatellite instability (MSI) testing or immunohistochemistry (IHC) in individuals with CRC at risk of LS, and of economic evidence relating to diagnostic strategies for LS. Reviews were carried out in April 2012 (test accuracy); and in February 2012, repeated in February 2013 (economic evaluations). Databases searched included MEDLINE (1946 to April week 3, 2012), EMBASE (1980 to week 17, 2012) and Web of Science (inception to 30 April 2012), and risk of bias for test accuracy was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) quality appraisal tool. A de novo economic model of diagnostic strategies for LS was developed. Inconsistencies in study designs precluded pooling of diagnostic test accuracy results from a previous systematic review and nine subsequent primary studies. These were of mixed quality, with significant methodological concerns identified for most. IHC and MSI can both play a part in diagnosing LS but neither is gold standard. No UK studies evaluated the cost-effectiveness of diagnosing and managing LS, although studies from other countries generally found some strategies to be cost-effective compared with no testing. The de novo model demonstrated that all strategies were cost-effective compared with no testing at a threshold of £20,000 per quality-adjusted life-year (QALY), with the most cost-effective strategy utilising MSI and BRAF testing [incremental cost-effectiveness ratio (ICER) = £5491 per QALY]. The maximum health benefit to the

  11. Defects level evaluation of LiTiZn ferrite ceramics using temperature dependence of initial permeability

    Science.gov (United States)

    Malyshev, A. V.; Petrova, A. B.; Sokolovskiy, A. N.; Surzhikov, A. P.

    2018-06-01

    The method for evaluating the integral defects level and chemical homogeneity of ferrite ceramics based on temperature dependence analysis of initial permeability is suggested. A phenomenological expression for the description of such dependence was suggested and an interpretation of its main parameters was given. It was shown, that the main criterion of the integral defects level of ferrite ceramics is relation of two parameters correlating with elastic stress value in a material. An indicator of structural perfection can be a maximum value of initial permeability close to Curie point as well. The temperature dependences of initial permeability have analyzed for samples sintered in laboratory conditions and for the ferrite industrial product. The proposed method allows controlling integral defects level of the soft ferrite products and has high sensitivity compare to typical X-ray methods.

  12. Experimental evaluation of the pressure and temperature dependence of ion-induced nucleation.

    Science.gov (United States)

    Munir, Muhammad Miftahul; Suhendi, Asep; Ogi, Takashi; Iskandar, Ferry; Okuyama, Kikuo

    2010-09-28

    An experimental system for the study of ion-induced nucleation in a SO(2)/H(2)O/N(2) gas mixture was developed, employing a soft x-ray at different pressure and temperature levels. The difficulties associated with these experiments included the changes in physical properties of the gas mixture when temperature and pressure were varied. Changes in the relative humidity (RH) as a function of pressure and temperature also had a significant effect on the different behaviors of the mobility distributions of particles. In order to accomplish reliable measurement and minimize uncertainties, an integrated on-line control system was utilized. As the pressure decreased in a range of 500-980 hPa, the peak concentration of both ions and nanometer-sized particles decreased, which suggests that higher pressure tended to enhance the growth of particles nucleated by ion-induced nucleation. Moreover, the modal diameters of the measured particle size distributions showed a systematic shift to larger sizes with increasing pressure. However, in the temperature range of 5-20 °C, temperature increases had no significant effects on the mobility distribution of particles. The effects of residence time, RH (7%-70%), and SO(2) concentration (0.08-6.7 ppm) on ion-induced nucleation were also systematically investigated. The results show that the nucleation and growth were significantly dependent on the residence time, RH, and SO(2) concentration, which is in agreement with both a previous model and previous observations. This research will be inevitable for a better understanding of the role of ions in an atmospheric nucleation mechanism.

  13. Economic evaluation of bone stimulation modalities: A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Button Melissa

    2009-01-01

    Full Text Available Various bone stimulation modalities are commonly used in treatment of fresh fractures and nonunions; however, the effectiveness and efficiency of these modalities remain uncertain. A systematic review of trials evaluating the clinical and economical outcomes of ultrasounds, electrical stimulation, and extracorporeal sound waves on fracture healing was conducted. We searched four electronic databases for economic evaluations that assessed bone stimulation modalities using ultrasound therapy, electrical stimulation, or extracorporeal shock waves. In addition, we searched the references and related articles of eligible studies, and a content expert was contacted. Information on the clinical and economical outcomes of patients was independently extracted by reviewers. Fourteen studies met the inclusion criteria; therefore, very limited research was found on the cost associated with treatments and the corresponding outcomes. The data available focus primarily on the efficacy of newly introduced treatment methods for bone growth, but failed to incorporate the costs of implementing such treatments. One economic analysis was identified that assessed different treatment paths using ultrasound. A total cost savings of 24-40% per patient occurred when ultrasound was used for fresh fractures and nonunions (grade C recommendation. The results suggest that the ultrasound is a viable alternative for bone stimulation; however, the impacts of the other modalities are left unknown due to the lack of research available. Methodological limitations leave the overall economic and clinical impact of these modalities uncertain. Large, prospective, randomized controlled trials that include cost-effectiveness analyses are needed to further define the clinical effectiveness and financial burden associated with bone stimulation modalities.

  14. The International Endometriosis Evaluation Program (IEEP Study) – A Systematic Study for Physicians, Researchers and Patients

    Science.gov (United States)

    Burghaus, S.; Fehm, T.; Fasching, P. A.; Blum, S.; Renner, S. K.; Baier, F.; Brodkorb, T.; Fahlbusch, C.; Findeklee, S.; Häberle, L.; Heusinger, K.; Hildebrandt, T.; Lermann, J.; Strahl, O.; Tchartchian, G.; Bojahr, B.; Porn, A.; Fleisch, M.; Reicke, S.; Füger, T.; Hartung, C.-P.; Hackl, J.; Beckmann, M. W.; Renner, S. P.

    2016-01-01

    Introduction: Endometriosis is a heterogeneous disease characterized by a range of different presentations. It is usually diagnosed when patients present with pain and/or infertility, but it has also been diagnosed in asymptomatic patients. Because of the different diagnostic approaches and diverse therapies, time to diagnosis can vary considerably and the definitive diagnosis may be delayed, with some cases not being diagnosed for several years. Endometriosis patients have many unmet needs. A systematic registration and follow-up of endometriosis patients could be useful to obtain an insight into the course of the disease. The validation of biomarkers could contribute to the development of diagnostic and predictive tests which could help select patients for surgical assessment earlier and offer better predictions about patients who might benefit from medical, surgical or other interventions. The aim is also to obtain a better understanding of the etiology, pathogenesis and progression of the disease. Material and Methods: To do this, an online multicenter documentation system was introduced to facilitate the establishment of a prospective multicenter case-control study, the IEEP (International Endometriosis Evaluation Program) study. We report here on the first 696 patients with endometriosis included in the program between June 2013 and June 2015. Results: A documentation system was created, and the structure and course of the study were mapped out with regard to data collection and the collection of biomaterials. Conclusion: The documentation system permits the history and clinical data of patients with endometriosis to be recorded. The IEEP combines this information with biomaterials and uses it for scientific studies. The recorded data can also be used to evaluate clinical quality control measures such as the certification parameters used by the EEL (European Endometriosis League) to assess certified endometriosis centers. PMID:27582581

  15. Evaluation of the measurement properties of symptom measurement instruments for atopic eczema: a systematic review.

    Science.gov (United States)

    Gerbens, L A A; Prinsen, C A C; Chalmers, J R; Drucker, A M; von Kobyletzki, L B; Limpens, J; Nankervis, H; Svensson, Å; Terwee, C B; Zhang, J; Apfelbacher, C J; Spuls, P I

    2017-01-01

    Symptoms have been identified as a core outcome domain for atopic eczema (AE) trials. Various instruments exist to measure symptoms in AE, but they vary in quality and there is a lack of standardization between clinical trials. Our objective was to systematically evaluate the quality of the evidence on the measurement properties of AE symptom instruments, thereby informing consensus discussions within the Harmonising Outcome Measures for Eczema (HOME) initiative regarding the most appropriate instruments for the core outcome domain symptoms. Using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and predefined criteria for good measurement properties on identified development and validation studies of AE symptom instruments, a best evidence synthesis was performed to draw an overall conclusion on quality of the instruments and to provide recommendations. Eighteen instruments were identified and evaluated. When the quality and results of the studies were considered, only five of these instruments had sufficient validation data to consider them for the core outcome set for the core outcome domain symptoms. These were the paediatric Itch Severity Scale (ISS), Patient-Oriented Eczema Measure (POEM), Patient-Oriented SCOring Atopic Dermatitis (PO-SCORAD), Self-Administered Eczema Area and Severity Index (SA-EASI) and adapted SA-EASI. ISS (paediatric version), POEM, PO-SCORAD, SA-EASI and adapted SA-EASI are currently the most appropriate instruments and therefore have the potential to be recommended as core symptom instrument in future clinical trials. These findings will be utilized for the development of a core outcome set for AE. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Neuroscience-related research in Ghana: a systematic evaluation of direction and capacity.

    Science.gov (United States)

    Quansah, Emmanuel; Karikari, Thomas K

    2016-02-01

    Neurological and neuropsychiatric diseases account for considerable healthcare, economic and social burdens in Ghana. In order to effectively address these burdens, appropriately-trained scientists who conduct high-impact neuroscience research will be needed. Additionally, research directions should be aligned with national research priorities. However, to provide information about current neuroscience research productivity and direction, the existing capacity and focus need to be identified. This would allow opportunities for collaborative research and training to be properly explored and developmental interventions to be better targeted. In this study, we sought to evaluate the existing capacity and direction of neuroscience-related research in Ghana. To do this, we examined publications reporting research investigations authored by scientists affiliated with Ghanaian institutions in specific areas of neuroscience over the last two decades (1995-2015). 127 articles that met our inclusion criteria were systematically evaluated in terms of research foci, annual publication trends and author affiliations. The most actively-researched areas identified include neurocognitive impairments in non-nervous system disorders, depression and suicide, epilepsy and seizures, neurological impact of substance misuse, and neurological disorders. These studies were mostly hospital and community-based surveys. About 60% of these articles were published in the last seven years, suggesting a recent increase in research productivity. However, data on experimental and clinical research outcomes were particularly lacking. We suggest that future investigations should focus on the following specific areas where information was lacking: large-scale disease epidemiology, effectiveness of diagnostic platforms and therapeutic treatments, and the genetic, genomic and molecular bases of diseases.

  17. The International Endometriosis Evaluation Program (IEEP Study) - A Systematic Study for Physicians, Researchers and Patients.

    Science.gov (United States)

    Burghaus, S; Fehm, T; Fasching, P A; Blum, S; Renner, S K; Baier, F; Brodkorb, T; Fahlbusch, C; Findeklee, S; Häberle, L; Heusinger, K; Hildebrandt, T; Lermann, J; Strahl, O; Tchartchian, G; Bojahr, B; Porn, A; Fleisch, M; Reicke, S; Füger, T; Hartung, C-P; Hackl, J; Beckmann, M W; Renner, S P

    2016-08-01

    Endometriosis is a heterogeneous disease characterized by a range of different presentations. It is usually diagnosed when patients present with pain and/or infertility, but it has also been diagnosed in asymptomatic patients. Because of the different diagnostic approaches and diverse therapies, time to diagnosis can vary considerably and the definitive diagnosis may be delayed, with some cases not being diagnosed for several years. Endometriosis patients have many unmet needs. A systematic registration and follow-up of endometriosis patients could be useful to obtain an insight into the course of the disease. The validation of biomarkers could contribute to the development of diagnostic and predictive tests which could help select patients for surgical assessment earlier and offer better predictions about patients who might benefit from medical, surgical or other interventions. The aim is also to obtain a better understanding of the etiology, pathogenesis and progression of the disease. To do this, an online multicenter documentation system was introduced to facilitate the establishment of a prospective multicenter case-control study, the IEEP (International Endometriosis Evaluation Program) study. We report here on the first 696 patients with endometriosis included in the program between June 2013 and June 2015. A documentation system was created, and the structure and course of the study were mapped out with regard to data collection and the collection of biomaterials. The documentation system permits the history and clinical data of patients with endometriosis to be recorded. The IEEP combines this information with biomaterials and uses it for scientific studies. The recorded data can also be used to evaluate clinical quality control measures such as the certification parameters used by the EEL (European Endometriosis League) to assess certified endometriosis centers.

  18. Economic evaluation of chronic disease self-management for people with diabetes: a systematic review.

    Science.gov (United States)

    Teljeur, C; Moran, P S; Walshe, S; Smith, S M; Cianci, F; Murphy, L; Harrington, P; Ryan, M

    2017-08-01

    To systematically review the evidence on the costs and cost-effectiveness of self-management support interventions for people with diabetes. Self-management support is the provision of education and supportive interventions to increase patients' skills and confidence in managing their health problems, potentially leading to improvements in HbA 1c levels in people with diabetes. Randomized controlled trials, observational studies or economic modelling studies were eligible for inclusion in the review. The target population was adults with diabetes. Interventions had to have a substantial component of self-management support and be compared with routine care. Study quality was evaluated using the Consensus on Health Economic Criteria and International Society of Pharmacoeconomic Outcomes Research questionnaires. A narrative review approach was used. A total of 16 costing and 21 cost-effectiveness studies of a range of self-management support interventions were identified. There was reasonably consistent evidence across 22 studies evaluating education self-management support programmes suggesting these interventions are cost-effective or superior to usual care. Telemedicine-type interventions were more expensive than usual care and potentially not cost-effective. There was insufficient evidence regarding the other types of self-management interventions, including pharmacist-led and behavioural interventions. The identified studies were predominantly of poor quality, with outcomes based on short-term follow-up data and study designs at high risk of bias. Self-management support education programmes may be cost-effective. There was limited evidence regarding other formats of self-management support interventions. The poor quality of many of the studies undermines the evidence base regarding the economic efficiency of self-management support interventions for people with diabetes. © 2016 Diabetes UK.

  19. An evaluation of a model for the systematic documentation of hospital based health promotion activities: results from a multicentre study

    DEFF Research Database (Denmark)

    Tønnesen, Hanne; Christensen, Mette E; Groene, Oliver

    2007-01-01

    The first step of handling health promotion (HP) in Diagnosis Related Groups (DRGs) is a systematic documentation and registration of the activities in the medical records. So far the possibility and tradition for systematic registration of clinical HP activities in the medical records...... and in patient administrative systems have been sparse. Therefore, the activities are mostly invisible in the registers of hospital services as well as in budgets and balances.A simple model has been described to structure the registration of the HP procedures performed by the clinical staff. The model consists...... of two parts; first part includes motivational counselling (7 codes) and the second part comprehends intervention, rehabilitation and after treatment (8 codes).The objective was to evaluate in an international study the usefulness, applicability and sufficiency of a simple model for the systematic...

  20. Systematic mapping review about costs and economic evaluations of skin conditions and diseases in the aged.

    Science.gov (United States)

    Lichterfeld-Kottner, Andrea; Hahnel, Elisabeth; Blume-Peytavi, Ulrike; Kottner, Jan

    2017-02-01

    Skin conditions and dermatological diseases associated with advanced age (e.g. fungal infection, dry skin and itch) receive increasingly attention in clinical practice and research. Cost and economic evaluations are important sources to inform priority setting and ressource allocation decisions in healthcare. The economics of skin conditions in aged populations has not been systematically reviewed so far. The aim of this mapping review was to summarize the economic evidence of selected skin conditions in the aged (65 + years). A mapping literature review and evidence summary was conducted. Searches were conducted in data bases Medline and Embase via OVID. Cinahl was searched using EBSCO. References lists of potential eligible studies, reviews, guidelines or other sources were screened for additional literature. For evaluation of methodological quality of full economic analyses the Consensus on Health Economic Criteria (CHEC) checklist was used. Database searches resulted in 1388 records. A total of 270 articles were read in full-text. Thirty-five publications were finally included in the data analysis reporting 38 economic analyses. Ten cost of illness analyses and 26 cost-effectiveness analyses reporting about pressure ulcers, skin tears, pressure ulcers, incontinence associated dermatitis and intertrigo/contact dermatitis/candidiasis treatment and prevention and onychomycosis testing were identified. Limited evidence indicated that low air loss beds were more cost effective than standard beds for prevention of pressure ulcers. Standardized skin care regimens seem to lower the incidence of pressure ulcers, skin tears and IAD but a cost saving effect was not always observed. Findings of this mapping review indicate that there is a paucity of high quality evidence regarding the economic impact of age-associated skin conditions and diseases. Substantial heterogeneity in terms of study design, evaluation perspective, time period, and way of cost estimation was

  1. Protocol: a systematic review of studies developing and/or evaluating search strategies to identify prognosis studies.

    Science.gov (United States)

    Corp, Nadia; Jordan, Joanne L; Hayden, Jill A; Irvin, Emma; Parker, Robin; Smith, Andrea; van der Windt, Danielle A

    2017-04-20

    Prognosis research is on the rise, its importance recognised because chronic health conditions and diseases are increasingly common and costly. Prognosis systematic reviews are needed to collate and synthesise these research findings, especially to help inform effective clinical decision-making and healthcare policy. A detailed, comprehensive search strategy is central to any systematic review. However, within prognosis research, this is challenging due to poor reporting and inconsistent use of available indexing terms in electronic databases. Whilst many published search filters exist for finding clinical trials, this is not the case for prognosis studies. This systematic review aims to identify and compare existing methodological filters developed and evaluated to identify prognosis studies of any of the three main types: overall prognosis, prognostic factors, and prognostic [risk prediction] models. Primary studies reporting the development and/or evaluation of methodological search filters to retrieve any type of prognosis study will be included in this systematic review. Multiple electronic bibliographic databases will be searched, grey literature will be sought from relevant organisations and websites, experts will be contacted, and citation tracking of key papers and reference list checking of all included papers will be undertaken. Titles will be screened by one person, and abstracts and full articles will be reviewed for inclusion independently by two reviewers. Data extraction and quality assessment will also be undertaken independently by two reviewers with disagreements resolved by discussion or by a third reviewer if necessary. Filters' characteristics and performance metrics reported in the included studies will be extracted and tabulated. To enable comparisons, filters will be grouped according to database, platform, type of prognosis study, and type of filter for which it was intended. This systematic review will identify all existing validated

  2. A systematic approach to the planning, implementation, monitoring, and evaluation of integrated health services.

    Science.gov (United States)

    Reynolds, Heidi W; Sutherland, Elizabeth G

    2013-05-06

    Because of the current emphasis and enthusiasm focused on integration of health systems, there is a risk of piling resources into integrated strategies without the necessary systems in place to monitor their progress adequately or to measure impact, and to learn from these efforts. The rush to intervene without adequate monitoring and evaluation will continue to result in a weak evidence base for decision making and resource allocation. Program planning and implementation are inextricability linked to monitoring and evaluation. Country level guidance is needed to identify country-specific integrated strategies, thereby increasing country ownership. This paper focuses on integrated health services but takes into account how health services are influenced by the health system, managed by programs, and made up of interventions. We apply the principles in existing comprehensive monitoring and evaluation (M&E) frameworks in order to outline a systematic approach to the M&E of integration for the country level. The approach is grounded by first defining the country-specific health challenges that integration is intended to affect. Priority points of contact for care can directly influence health, and essential packages of integration for all major client presentations need to be defined. Logic models are necessary to outline the plausible causal pathways and define the inputs, roles and responsibilities, indicators, and data sources across the health system. Finally, we recommend improvements to the health information system and in data use to ensure that data are available to inform decisions, because changes in the M&E function to make it more integrated will also facilitate integration in the service delivery, planning, and governance components. This approach described in the paper is the ideal, but its application at the country level can help reveal gaps and guide decisions related to what health services to prioritize for integration, help plan for how to

  3. Systematic evaluation of the Cernavoda nuclear power plant physical protection system

    International Nuclear Information System (INIS)

    Ionescu, D.S.

    2002-01-01

    Full text: For three years at Cernavoda NPP is working a process to systematic evaluating the effectiveness of the Physical Protection System (PPS). Due to the fact that this evaluation has to be continuous, the first important step is to define a baseline to compare periodically the performance of PPS against it. The necessity of that process has been identified as follows: the continuous changes in the field of perceived threats against Cernavoda NPP and the necessary measures to respond to that changing climate; the needful to improve the performance of PPS against certain threats in conjunction with the needful to allocate substantially financial and human resources to cover the discovered weakness in the system; an assistant to take the appropriate measure in case of indisponibility of one or more components or parts of the PPS. The second step is the continuous tracking of the behavior of PPS in order to determine: the maintenance resource allocation and the priorities of the work; the predictive behavior of installed components to determine the future appropriate measures, including budget dimensioning. SAVI is a PC compatible program developed by SANDIA Laboratory (USA) for comprehensive analysis of PPS effectiveness. That program is organized in two modules: the Adversary Sequence Diagram (ASD) module and the outsider module modeling trough specific codes both the characteristics of PPS and of the predicted adversary. Combining the two modules related to a specific PPS and adversary is possible to find out the effectiveness of the physical protection system for each vital zone along to ten possible paths to penetrate by adversary, starting with the most vulnerable one. Because of two conservative assumption considered by the SAVI algorithm (adversary know the PPS characteristics and they use an optimal penetration strategy), the measure of effectiveness (probability of interruption - P I ) is very realistic and conservative related to the necessary

  4. [Report quality evaluation of systematic review or Meta-analysis published in China Journal of Chinese Materia Medica].

    Science.gov (United States)

    Zhang, Yan; Yu, Dan-Dan; Cui, De-Hua; Liao, Xing; Guo, Hua

    2018-03-01

    To evaluate the report quality of intervention-related systematic reviews or Meta-analysis published in China Journal of Chinese Materia Medica, we searched CNKI and China Journal of Chinese Materia Medica webpages to collect intervention-related systematic reviews or Meta-analysis since the first issue of the magazine. A total of 40 systematic reviews or Meta-analysis reports were included, including one network Meta-analysis. According to the PRISMA statement published in 2009, the report quality of the systematic reviews or Meta-analysis was evaluated. According to the results, 3 had the low quality, 30 had the medium quality, and 7 had the high quality. The average score for all of items was 30 points (21-30.5 points for the medium quality). The 17 high-quality (31-40 points) report items were title, rationale, objectives, information sources, study selection, data collection process, data items, risk of bias in individual studies, summary measures, risk of bias across studies, study selection, study characteristics, risk of bias within studies, results of individual studies, synthesis of results, risk of bias across studies and funding; the 4 medium-quality (21-30.5 points) reporting items were eligibility criteria, search, limitations and conclusions; and the 6 low-quality (Materia Medica is medium, and it is necessary to improve the quality standard of the report. Copyright© by the Chinese Pharmaceutical Association.

  5. Slotted rotatable target assembly and systematic error analysis for a search for long range spin dependent interactions from exotic vector boson exchange using neutron spin rotation

    Science.gov (United States)

    Haddock, C.; Crawford, B.; Fox, W.; Francis, I.; Holley, A.; Magers, S.; Sarsour, M.; Snow, W. M.; Vanderwerp, J.

    2018-03-01

    We discuss the design and construction of a novel target array of nonmagnetic test masses used in a neutron polarimetry measurement made in search for new possible exotic spin dependent neutron-atominteractions of Nature at sub-mm length scales. This target was designed to accept and efficiently transmit a transversely polarized slow neutron beam through a series of long open parallel slots bounded by flat rectangular plates. These openings possessed equal atom density gradients normal to the slots from the flat test masses with dimensions optimized to achieve maximum sensitivity to an exotic spin-dependent interaction from vector boson exchanges with ranges in the mm - μm regime. The parallel slots were oriented differently in four quadrants that can be rotated about the neutron beam axis in discrete 90°increments using a Geneva drive. The spin rotation signals from the 4 quadrants were measured using a segmented neutron ion chamber to suppress possible systematic errors from stray magnetic fields in the target region. We discuss the per-neutron sensitivity of the target to the exotic interaction, the design constraints, the potential sources of systematic errors which could be present in this design, and our estimate of the achievable sensitivity using this method.

  6. SYSTEMATIC SCANNING ELECTRON MICROSCOPY TECHNIQUE FOR EVALUATING COMBINED BIOLOIGCAL/GRANULAR ACTIVATED CARBON TREATMENT PROCESSES

    Science.gov (United States)

    A systematic scanning election microscope analytical technique has been developed to examine granular activated carbon used a a medium for biomass attachment in liquid waste treatment. The procedure allows for the objective monitoring, comparing, and trouble shooting of combined ...

  7. A study on the dependency evaluation for multiple human actions in human reliability analysis of probabilistic safety assessment

    International Nuclear Information System (INIS)

    Kang, D. I.; Yang, J. E.; Jung, W. D.; Sung, T. Y.; Park, J. H.; Lee, Y. H.; Hwang, M. J.; Kim, K. Y.; Jin, Y. H.; Kim, S. C.

    1997-02-01

    This report describes the study results on the method of the dependency evaluation and the modeling, and the limited value of human error probability (HEP) for multiple human actions in accident sequences of probabilistic safety assessment (PSA). THERP and Parry's method, which have been generally used in dependency evaluation of human reliability analysis (HRA), are introduced and their limitations are discussed. New dependency evaluation method in HRA is established to make up for the weak points of THERP and Parry's methods. The limited value of HEP is also established based on the review of several HRA related documents. This report describes the definition, the type, the evaluation method, and the evaluation example of dependency to help the reader's understanding. It is expected that this study results will give a guidance to HRA analysts in dependency evaluation of multiple human actions and enable PSA analysts to understand HRA in detail. (author). 23 refs., 3 tabs., 2 figs

  8. A novel time dependent gamma evaluation function for dynamic 2D and 3D dose distributions

    International Nuclear Information System (INIS)

    Podesta, Mark; Persoon, Lucas CGG; Verhaegen, Frank

    2014-01-01

    Modern external beam radiotherapy requires detailed verification and quality assurance so that confidence can be placed on both the delivery of a single treatment fraction and on the consistency of delivery throughout the treatment course. To verify dose distributions, a comparison between prediction and measurement must be made. Comparisons between two dose distributions are commonly performed using a Gamma evaluation which is a calculation of two quantities on a pixel by pixel basis; the dose difference, and the distance to agreement. By providing acceptance criteria (e.g. 3%, 3 mm), the function will find the most appropriate match within its two degrees of freedom. For complex dynamic treatments such as IMRT or VMAT it is important to verify the dose delivery in a time dependent manner and so a gamma evaluation that includes a degree of freedom in the time domain via a third parameter, time to agreement, is presented here. A C++ (mex) based gamma function was created that could be run on either CPU and GPU computing platforms that would allow a degree of freedom in the time domain. Simple test cases were created in both 2D and 3D comprising of simple geometrical shapes with well-defined boundaries varying over time. Changes of varying magnitude in either space or time were introduced and repeated gamma analyses were performed varying the criteria. A clinical VMAT case was also included, artificial air bubbles of varying size were introduced to a patient geometry, along with shifts of varying magnitude in treatment time. For all test cases where errors in distance, dose or time were introduced, the time dependent gamma evaluation could accurately highlight the errors. The time dependent gamma function presented here allows time to be included as a degree of freedom in gamma evaluations. The function allows for 2D and 3D data sets which are varying over time to be compared using appropriate criteria without penalising minor offsets of subsequent radiation

  9. Measurement, Classification and Evaluation of Sleep Disturbance in Psoriasis: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Alasdair L Henry

    Full Text Available Psoriasis is a long-term immune-mediated inflammatory disorder mainly, but not only, affecting skin, and is associated with significant medical and psychological morbidity. Evidence suggests that sleep is disrupted in psoriasis, however high quality empirical evidence is lacking. Given the importance of sleep for health, characterisation of sleep disruption in psoriasis is an important goal. We therefore conducted a systematic review of the sleep-psoriasis literature.Searches were conducted in Pubmed, SCOPUS and Web of Science from inception to May 2016. Studies were compared against inclusion/exclusion criteria and underwent a quality evaluation. Given the heterogeneity of studies, we conducted a narrative synthesis of the findings.Searches revealed 32 studies which met our predetermined inclusion/exclusion criteria. Whilst 93.7% of studies reported sleep disruption in this population, ranging from 0.05% to 85.4%, many had important methodological shortcomings. Over half of all quantitative studies (54.8%; 17/31 relied on non-validated measures, contributing to heterogeneity in study findings. In those that employed valid measures, assessing sleep was often not the primary objective. We frequently found the absence of adequate sample size calculations and poor statistical reporting.This review showed that in psoriasis, reported sleep rates of sleep disturbance varied substantially. Most studies lacked a hypothesis driven research question and/or failed to use validated measures of sleep. We were unable to draw firm conclusions about the precise prevalence and nature of sleep disturbance within the psoriasis population. We offer suggestions to help advance understanding of sleep disturbance in psoriasis.

  10. Pharyngeal Residue Severity Rating Scales Based on Fiberoptic Endoscopic Evaluation of Swallowing: A Systematic Review.

    Science.gov (United States)

    Neubauer, Paul D; Hersey, Denise P; Leder, Steven B

    2016-06-01

    Identification of pharyngeal residue severity located in the valleculae and pyriform sinuses has always been a primary goal during fiberoptic endoscopic evaluation of swallowing (FEES). Pharyngeal residue is a clinical sign of potential prandial aspiration making an accurate description of its severity an important but difficult challenge. A reliable, validated, and generalizable pharyngeal residue severity rating scale for FEES would be beneficial. A systematic review of the published English language literature since 1995 was conducted to determine the quality of existing pharyngeal residue severity rating scales based on FEES. Databases were searched using controlled vocabulary words and synonymous free text words for topics of interest (deglutition disorders, pharyngeal residue, endoscopy, videofluoroscopy, fiberoptic technology, aspiration, etc.) and outcomes of interest (scores, scales, grades, tests, FEES, etc.). Search strategies were adjusted for syntax appropriate for each database/platform. Data sources included MEDLINE (OvidSP 1946-April Week 3 2015), Embase (OvidSP 1974-2015 April 20), Scopus (Elsevier), and the unindexed material in PubMed (NLM/NIH) were searched for relevant articles. Supplementary efforts to identify studies included checking reference lists of articles retrieved. Scales were compared using qualitative properties (sample size, severity definitions, number of raters, and raters' experience and training) and psychometric analyses (randomization, intra- and inter-rater reliability, and construct validity). Seven articles describing pharyngeal residue severity rating scales met inclusion criteria. Six of seven scales had insufficient data to support their use as evidenced by methodological weaknesses with both qualitative properties and psychometric analyses. There is a need for qualitative and psychometrically reliable, validated, and generalizable pharyngeal residue severity rating scales that are anatomically specific, image

  11. Quantifying Overdiagnosis in Cancer Screening: A Systematic Review to Evaluate the Methodology.

    Science.gov (United States)

    Ripping, Theodora M; Ten Haaf, Kevin; Verbeek, André L M; van Ravesteyn, Nicolien T; Broeders, Mireille J M

    2017-10-01

    Overdiagnosis is the main harm of cancer screening programs but is difficult to quantify. This review aims to evaluate existing approaches to estimate the magnitude of overdiagnosis in cancer screening in order to gain insight into the strengths and limitations of these approaches and to provide researchers with guidance to obtain reliable estimates of overdiagnosis in cancer screening. A systematic review was done of primary research studies in PubMed that were published before January 1, 2016, and quantified overdiagnosis in breast cancer screening. The studies meeting inclusion criteria were then categorized by their methods to adjust for lead time and to obtain an unscreened reference population. For each approach, we provide an overview of the data required, assumptions made, limitations, and strengths. A total of 442 studies were identified in the initial search. Forty studies met the inclusion criteria for the qualitative review. We grouped the approaches to adjust for lead time in two main categories: the lead time approach and the excess incidence approach. The lead time approach was further subdivided into the mean lead time approach, lead time distribution approach, and natural history modeling. The excess incidence approach was subdivided into the cumulative incidence approach and early vs late-stage cancer approach. The approaches used to obtain an unscreened reference population were grouped into the following categories: control group of a randomized controlled trial, nonattenders, control region, extrapolation of a prescreening trend, uninvited groups, adjustment for the effect of screening, and natural history modeling. Each approach to adjust for lead time and obtain an unscreened reference population has its own strengths and limitations, which should be taken into consideration when estimating overdiagnosis. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  12. Cost-benefit evaluation of systematic radiological diagnosis of congenital dislocated hip

    International Nuclear Information System (INIS)

    Faure, C.; Schmit, P.; Salvat, D.

    1984-01-01

    The interest of radiological mass screening of congential dislocated hip is still debated. We have tried to evaluate the cost-benefit ratio of radiological detection at the age of 3-4 months, taking into account the socio-economic cost and radiation risk. Assuming a frequency of this disorder of 1% the average cost of treatment of one case detected by X-ray screening at the age of 3-4 months, including the price of X-ray examinations of 99 normal babies is 23.374 FF. The average cost of treatment of a case detected at walking-age, i.e. after 9 months, is 84.230 FF. The cost-benefit ratio is 3.6. In countries where the frequency reaches 2% the cost benefit ratio is 4.57. It also appears from our study that the irradiation of the patient is much smaller when the diagnosis is made earlier. Comparing the slight irradiation delivered to normal infants by this mass screening to the heavy irradiation received by a few individuals whose treatment is started after 9 months, the calculated risk of leukemia or of genetic disorder for the whole population still favours a systematic X-ray film of the pelvis at age 3-4 months. However, if it were decided to make obligatory this mass radiological detection programme during the fourth month of life, this would necessitate a serious effort to train all radiologists to obtain adequate films with the best radiation protection. (orig.)

  13. Computer tool to evaluate the cue reactivity of chemically dependent individuals.

    Science.gov (United States)

    Silva, Meire Luci da; Frère, Annie France; Oliveira, Henrique Jesus Quintino de; Martucci Neto, Helio; Scardovelli, Terigi Augusto

    2017-03-01

    Anxiety is one of the major influences on the dropout of relapse and treatment of substance abuse treatment. Chemically dependent individuals need (CDI) to be aware of their emotional state in situations of risk during their treatment. Many patients do not agree with the diagnosis of the therapist when considering them vulnerable to environmental stimuli related to drugs. This research presents a cue reactivity detection tool based on a device acquiring physiological signals connected to personal computer. Depending on the variations of the emotional state of the drug addict, alteration of the physiological signals will be detected by the computer tool (CT) which will modify the displayed virtual sets without intervention of the therapist. Developed in 3ds Max® software, the CT is composed of scenarios and objects that are in the habit of marijuana and cocaine dependent individual's daily life. The interaction with the environment is accomplished using a Human-Computer Interface (HCI) that converts incoming physiological signals indicating anxiety state into commands that change the scenes. Anxiety was characterized by the average variability from cardiac and respiratory rate of 30 volunteers submitted stress environment situations. To evaluate the effectiveness of cue reactivity a total of 50 volunteers who were marijuana, cocaine or both dependent were accompanied. Prior to CT, the results demonstrated a poor correlation between the therapists' predictions and those of the chemically dependent individuals. After exposure to the CT, there was a significant increase of 73% in awareness of the risks of relapse. We confirmed the hypothesis that the CT, controlled only by physiological signals, increases the perception of vulnerability to risk situations of individuals with dependence on marijuana, cocaine or both. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Evaluation and Windspeed Dependence of MODIS Aerosol Retrievals Over Open Ocean

    Science.gov (United States)

    Kleidman, Richard G.; Smirnov, Alexander; Levy, Robert C.; Mattoo, Shana; Tanre, Didier

    2011-01-01

    The Maritime Aerosol Network (MAN) data set provides high quality ground-truth to validate the MODIS aerosol product over open ocean. Prior validation of the ocean aerosol product has been limited to coastal and island sites. Comparing MODIS Collection 5 ocean aerosol retrieval products with collocated MAN measurements from ships shows that MODIS is meeting the pre-launch uncertainty estimates for aerosol optical depth (AOD) with 64% and 67% of retrievals at 550 nm, and 74% and 78% of retrievals at 870 nm, falling within expected uncertainty for Terra and Aqua, respectively. Angstrom Exponent comparisons show a high correlation between MODIS retrievals and shipboard measurements (R= 0.85 Terra, 0.83 Aqua), although the MODIS aerosol algorithm tends to underestimate particle size for large particles and overestimate size for small particles, as seen in earlier Collections. Prior analysis noted an offset between Terra and Aqua ocean AOD, without concluding which sensor was more accurate. The simple linear regression reported here, is consistent with other anecdotal evidence that Aqua agreement with AERONET is marginally better. However we cannot claim based on the current study that the better Aqua comparison is statistically significant. Systematic increase of error as a function of wind speed is noted in both Terra and Aqua retrievals. This wind speed dependency enters the retrieval when winds deviate from the 6 m/s value assumed in the rough ocean surface and white cap parameterizations. Wind speed dependency in the results can be mitigated by using auxiliary NCEP wind speed information in the retrieval process.

  15. A Systematic Analysis of Factors Localized to Damaged Chromatin Reveals PARP-Dependent Recruitment of Transcription Factors.

    Science.gov (United States)

    Izhar, Lior; Adamson, Britt; Ciccia, Alberto; Lewis, Jedd; Pontano-Vaites, Laura; Leng, Yumei; Liang, Anthony C; Westbrook, Thomas F; Harper, J Wade; Elledge, Stephen J

    2015-06-09

    Localization to sites of DNA damage is a hallmark of DNA damage response (DDR) proteins. To identify DDR factors, we screened epitope-tagged proteins for localization to sites of chromatin damaged by UV laser microirradiation and found >120 proteins that localize to damaged chromatin. These include the BAF tumor suppressor complex and the amyotrophic lateral sclerosis (ALS) candidate protein TAF15. TAF15 contains multiple domains that bind damaged chromatin in a poly-(ADP-ribose) polymerase (PARP)-dependent manner, suggesting a possible role as glue that tethers multiple PAR chains together. Many positives were transcription factors; > 70% of randomly tested transcription factors localized to sites of DNA damage, and of these, ∼90% were PARP dependent for localization. Mutational analyses showed that localization to damaged chromatin is DNA-binding-domain dependent. By examining Hoechst staining patterns at damage sites, we see evidence of chromatin decompaction that is PARP dependent. We propose that PARP-regulated chromatin remodeling at sites of damage allows transient accessibility of DNA-binding proteins. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  16. A Systematic Analysis of Factors Localized to Damaged Chromatin Reveals PARP-Dependent Recruitment of Transcription Factors

    Directory of Open Access Journals (Sweden)

    Lior Izhar

    2015-06-01

    Full Text Available Localization to sites of DNA damage is a hallmark of DNA damage response (DDR proteins. To identify DDR factors, we screened epitope-tagged proteins for localization to sites of chromatin damaged by UV laser microirradiation and found >120 proteins that localize to damaged chromatin. These include the BAF tumor suppressor complex and the amyotrophic lateral sclerosis (ALS candidate protein TAF15. TAF15 contains multiple domains that bind damaged chromatin in a poly-(ADP-ribose polymerase (PARP-dependent manner, suggesting a possible role as glue that tethers multiple PAR chains together. Many positives were transcription factors; > 70% of randomly tested transcription factors localized to sites of DNA damage, and of these, ∼90% were PARP dependent for localization. Mutational analyses showed that localization to damaged chromatin is DNA-binding-domain dependent. By examining Hoechst staining patterns at damage sites, we see evidence of chromatin decompaction that is PARP dependent. We propose that PARP-regulated chromatin remodeling at sites of damage allows transient accessibility of DNA-binding proteins.

  17. A systematic review and economic evaluation of exercise referral schemes in primary care: a short report.

    Science.gov (United States)

    Campbell, Fiona; Holmes, Mike; Everson-Hock, Emma; Davis, Sarah; Buckley Woods, Helen; Anokye, Nana; Tappenden, Paul; Kaltenthaler, Eva

    2015-07-01

    , Moxham T, Fox KR, et al. The clinical effectiveness and cost-effectiveness of exercise referral schemes: a systematic review and economic evaluation. Health Technol Assess 2011;15(44)] to give a total of eight studies with 5190 participants. The proportion of individuals achieving 90-150 minutes of at least moderate-intensity activity per week at 6-12 months' follow-up was greater for ERSs than usual care (relative risk 1.12; 95% confidence interval 1.04 to 1.20). Older patients and those referred for CHD risk factors appeared to be more likely than others to increase their levels of physical activity. Qualitative evidence suggests that interventions enabling the development of social support networks are beneficial in promoting uptake and adherence. Exercise referral gained 0.003 quality-adjusted life-years (QALYs) at an additional cost of £225 per person. The estimated mean incremental cost-effectiveness ratio (ICER) in the probabilistic sensitivity analysis was £76,276. In the univariate sensitivity analysis the results were very sensitive (ICERs ranged from  £100,000) to changes in the effect of ERSs on physical activity uptake and the duration of the protective effects and the direct health-related quality-of-life gains attributable to physical activity. Exercise referral schemes result in a small improvement in the number of people who increase their levels of physical activity. The cost-effectiveness analysis indicates that the ICER for ERSs compared with usual care is around £76,000 per QALY, although the cost-effectiveness of ERSs is subject to considerable uncertainty. This study is registered as PROSPERO CRD42013005200. National Institute for Health Research Health Technology Assessment programme.

  18. Do caffeine-containing analgesics promote dependence? A review and evaluation.

    Science.gov (United States)

    Feinstein, A R; Heinemann, L A; Dalessio, D; Fox, J M; Goldstein, J; Haag, G; Ladewig, D; O'Brien, C P

    2000-11-01

    Debates about the suspected association between kidney disease and use of analgesics have led to concern about whether caffeine could stimulate an undesirable overuse of phenacetin-free combined analgesics. A committee was asked to critically review the pertinent literature and to suggest guides for clinical practice and for consideration of international regulatory authorities. A group of international scientists, jointly selected by the regulatory authorities of Germany, Switzerland, and Austria and the pharmaceutical industry. All invited experts evaluated relevant literature and reports and added further information and comments. Caffeine has a synergistic effectiveness with analgesics. Although caffeine has a dependence potential, the potential is low. Experimental data regarding dependence potential for caffeine alone may not correspond to the conditions in patients with pain. Withdrawal is not likely to cause stimulation or sustainment of analgesic intake. For drug-induced headache, no single or combined analgesic was consistently identified as causative, and no evidence exists for a special role of caffeine. Strong dependence behavior was observed only in patients using phenacetin-containing preparations, coformulated with antipyretics/analgesics and caffeine. This finding may have led to the impression that caffeine stimulates overuse of analgesics. Although more experimental and long-term data would be desirable to show possible mechanisms of dependence and to offer unequivocal proof of safety, the committee concluded that the available evidence does not support the claim that analgesics coformulated with caffeine, in the absence of phenacetin, stimulate or sustain overuse.

  19. Evaluating the impact of healthcare provider training to improve tuberculosis management: a systematic review of methods and outcome indicators used.

    Science.gov (United States)

    Wu, Shishi; Roychowdhury, Imara; Khan, Mishal

    2017-03-01

    Developing human resources capacity is vital for tuberculosis (TB) control in low- and middle-income countries. Although investments in TB healthcare provider (HCP) training programmes have increased, it is unclear whether these are robustly evaluated. The objective of this systematic review was to synthesize the methods and outcome indicators used to assess TB HCP training programmes. A systematic scoping review of publications reporting on evaluations of training programmes for TB HCPs - including doctors, nurses, paramedics, and lay health workers - was conducted through a search in three electronic databases, Google Scholar, and five websites of non-profit organizations. Data on the study location, population trained, outcomes assessed, and evaluation approach were extracted. After screening 499 unique publications, 21 were eligible for inclusion in the analysis. The majority of evaluations were conducted in Africa. The most common evaluation methods were a review of patient records (n=8, 38%) and post-training interview with trainees (n=7, 33%). In terms of outcomes, more than half of the studies (n=12, 57%) evaluated knowledge acquisition of trainees, with only six (29%) assessing on-the-job behaviour change. Even though more funds have been invested in TB HCP training, publications from robust evaluations assessing the impact on quality of care and behaviour change are limited. Copyright © 2016. Published by Elsevier Ltd.

  20. An evaluation of systematic tuberculosis screening at private facilities in Karachi, Pakistan.

    Directory of Open Access Journals (Sweden)

    Jacob Creswell

    Full Text Available BACKGROUND: In Pakistan, like many Asian countries, a large proportion of healthcare is provided through the private sector. We evaluated a systematic screening strategy to identify people with tuberculosis in private facilities in Karachi and assessed the approaches' ability to diagnose patients earlier in their disease progression. METHODS AND FINDINGS: Lay workers at 89 private clinics and a large hospital outpatient department screened all attendees for tuberculosis using a mobile phone-based questionnaire during one year. The number needed to screen to detect a case of tuberculosis was calculated. To evaluate early diagnosis, we tested for differences in cough duration and smear grading by screening facility. 529,447 people were screened, 1,010 smear-positive tuberculosis cases were detected and 942 (93.3% started treatment, representing 58.7% of all smear-positive cases notified in the intervention area. The number needed to screen to detect a smear-positive case was 124 (prevalence 806/100,000 at the hospital and 763 (prevalence 131/100,000 at the clinics; however, ten times the number of individuals were screened in clinics. People with smear-positive TB detected at the hospital were less likely to report cough lasting 2-3 weeks (RR 0.66 95%CI [0.49-0.90] and more likely to report cough duration >3 weeks (RR 1.10 95%CI [1.03-1.18]. Smear-positive cases at the clinics were less likely to have a +3 grade (RR 0.76 95%CI [0.63-0.92] and more likely to have +1 smear grade (RR 1.24 95%CI [1.02-1.51]. CONCLUSIONS: Tuberculosis screening at private facilities is acceptable and can yield large numbers of previously undiagnosed cases. Screening at general practitioner clinics may find cases earlier than at hospitals although more people must be screened to identify a case of tuberculosis. Limitations include lack of culture testing, therefore underestimating true TB prevalence. Using more sensitive and specific screening and diagnostic tests such

  1. An evaluation of systematic tuberculosis screening at private facilities in Karachi, Pakistan.

    Science.gov (United States)

    Creswell, Jacob; Khowaja, Saira; Codlin, Andrew; Hashmi, Rabia; Rasheed, Erum; Khan, Mubashir; Durab, Irfan; Mergenthaler, Christina; Hussain, Owais; Khan, Faisal; Khan, Aamir J

    2014-01-01

    In Pakistan, like many Asian countries, a large proportion of healthcare is provided through the private sector. We evaluated a systematic screening strategy to identify people with tuberculosis in private facilities in Karachi and assessed the approaches' ability to diagnose patients earlier in their disease progression. Lay workers at 89 private clinics and a large hospital outpatient department screened all attendees for tuberculosis using a mobile phone-based questionnaire during one year. The number needed to screen to detect a case of tuberculosis was calculated. To evaluate early diagnosis, we tested for differences in cough duration and smear grading by screening facility. 529,447 people were screened, 1,010 smear-positive tuberculosis cases were detected and 942 (93.3%) started treatment, representing 58.7% of all smear-positive cases notified in the intervention area. The number needed to screen to detect a smear-positive case was 124 (prevalence 806/100,000) at the hospital and 763 (prevalence 131/100,000) at the clinics; however, ten times the number of individuals were screened in clinics. People with smear-positive TB detected at the hospital were less likely to report cough lasting 2-3 weeks (RR 0.66 95%CI [0.49-0.90]) and more likely to report cough duration >3 weeks (RR 1.10 95%CI [1.03-1.18]). Smear-positive cases at the clinics were less likely to have a +3 grade (RR 0.76 95%CI [0.63-0.92]) and more likely to have +1 smear grade (RR 1.24 95%CI [1.02-1.51]). Tuberculosis screening at private facilities is acceptable and can yield large numbers of previously undiagnosed cases. Screening at general practitioner clinics may find cases earlier than at hospitals although more people must be screened to identify a case of tuberculosis. Limitations include lack of culture testing, therefore underestimating true TB prevalence. Using more sensitive and specific screening and diagnostic tests such as chest x-ray and Xpert MTB/RIF may improve results.

  2. Failure mechanism dependence and reliability evaluation of non-repairable system

    International Nuclear Information System (INIS)

    Chen, Ying; Yang, Liu; Ye, Cui; Kang, Rui

    2015-01-01

    Reliability study of electronic system with the physics-of-failure method has been promoted due to the increase knowledge of electronic failure mechanisms. System failure initiates from independent failure mechanisms, have effect on or affect by other failure mechanisms and finally result in system failure. Failure mechanisms in a non-repairable system have many kinds of correlation. One failure mechanism developing to a certain degree will trigger, accelerate or inhibit another or many other failure mechanisms, some kind of failure mechanisms may have the same effect on the failure site, component or system. The destructive effect will be accumulated and result in early failure. This paper presents a reliability evaluation method considering correlativity among failure mechanisms, which includes trigger, acceleration, inhibition, accumulation, and competition. Based on fundamental rule of physics of failure, decoupling methods of these correlations are discussed. With a case, reliability of electronic system is evaluated considering failure mechanism dependence. - Highlights: • Five types of failure mechanism correlations are described. • Decoupling methods of these correlations are discussed. • A reliability evaluation method considering mechanism dependence is proposed. • Results are quite different to results under failure independence assumption

  3. Embodied simulation as part of affective evaluation processes: task dependence of valence concordant EMG activity.

    Science.gov (United States)

    Weinreich, André; Funcke, Jakob Maria

    2014-01-01

    Drawing on recent findings, this study examines whether valence concordant electromyography (EMG) responses can be explained as an unconditional effect of mere stimulus processing or as somatosensory simulation driven by task-dependent processing strategies. While facial EMG over the Corrugator supercilii and the Zygomaticus major was measured, each participant performed two tasks with pictures of album covers. One task was an affective evaluation task and the other was to attribute the album covers to one of five decades. The Embodied Emotion Account predicts that valence concordant EMG is more likely to occur if the task necessitates a somatosensory simulation of the evaluative meaning of stimuli. Results support this prediction with regard to Corrugator supercilii in that valence concordant EMG activity was only present in the affective evaluation task but not in the non-evaluative task. Results for the Zygomaticus major were ambiguous. Our findings are in line with the view that EMG activity is an embodied part of the evaluation process and not a mere physical outcome.

  4. Evaluation of patient involvement in a systematic review and meta-analysis of individual patient data in cervical cancer treatment

    Directory of Open Access Journals (Sweden)

    Vale Claire L

    2012-05-01

    Full Text Available Abstract Background In April 2005, researchers based at the Medical Research Council Clinical Trials Unit, set out to involve women affected by cervical cancer in a systematic review and meta-analysis of individual patient data to evaluate treatments for this disease. Each of the women had previously been treated for cervical cancer. Following completion of the meta-analysis, we aimed to evaluate the process of involvement from the researcher and research partner perspective. Methods An advisory group was first established to give advice on recruiting, supporting and involving women and led to efforts to recruit women to take part in the systematic review using different approaches. Evaluation of the process and outcomes of the partnership between the systematic reviewers and the patients, in respect to what the partnership achieved; what worked well and what were the difficulties; what was learned and the resource requirements, took place during the conduct of the meta-analysis and again after completion of the project. Results Six women, each of whom had received treatments for cervical cancer, were recruited as Patient Research Partners and five of these women subsequently took part in a variety of activities around the systematic review. They attended progress meetings and all but one attended a meeting at which the first results of the review were presented to all collaborators and gave feedback. Three of the women also became involved in a further related research project which led to an editorial publication from the patient perspective and also participated, along with two lead researchers, in the evaluation of the process and outcomes. While they were generally positive about the experience, one Patient Research Partner questioned the extent of the impact patients could make to the systematic review process. Conclusions In general, researchers and patient research partners felt that they had learned a lot from the process and considered

  5. Incidence of iatrogenic opioid dependence or abuse in patients with pain who were exposed to opioid analgesic therapy: a systematic review and meta-analysis.

    Science.gov (United States)

    Higgins, C; Smith, B H; Matthews, K

    2018-06-01

    The prevalence and incidence of chronic conditions, such as pain and opioid dependence, have implications for policy development, resource allocation, and healthcare delivery. The primary objective of the current review was to estimate the incidence of iatrogenic opioid dependence or abuse after treatment with opioid analgesics. Systematic electronic searches utilised six research databases (Embase, Medline, PubMed, Cinahl Plus, Web of Science, OpenGrey). A 'grey' literature search and a reference search of included articles were also undertaken. The PICOS framework was used to develop search strategies and the findings are reported in accordance with the PRISMA Statement. After eligibility reviews of 6164 articles, 12 studies (involving 310 408 participants) were retained for inclusion in the meta-analyses. A random effects model (DerSimonian-Laird method) generated a pooled incidence of opioid dependence or abuse of 4.7%. There was little within-study risk of bias and no significant publication bias; however, substantial heterogeneity was found among study effects (99.78%). Sensitivity analyses indicated that the diagnostic criteria selected for identifying opioid dependence or abuse (Diagnostic Statistical Manual (DSM-IV) vs International Classification of Diseases (ICD-9)) accounted for 20% and duration of exposure to opioid analgesics accounted for 18% of variance in study effects. Longer-term opioid analgesic exposure, and prescription of strong rather than weak opioids, were associated with a significantly lower incidence of opioid dependence or abuse. The incidence of iatrogenic opioid dependence or abuse was 4.7% of those prescribed opioids for pain. Further research is required to confirm the potential for our findings to inform prevention of this serious adverse event. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

  6. Psychometric Properties of Patient-Facing eHealth Evaluation Measures: Systematic Review and Analysis.

    Science.gov (United States)

    Wakefield, Bonnie J; Turvey, Carolyn L; Nazi, Kim M; Holman, John E; Hogan, Timothy P; Shimada, Stephanie L; Kennedy, Diana R

    2017-10-11

    Significant resources are being invested into eHealth technology to improve health care. Few resources have focused on evaluating the impact of use on patient outcomes A standardized set of metrics used across health systems and research will enable aggregation of data to inform improved implementation, clinical practice, and ultimately health outcomes associated with use of patient-facing eHealth technologies. The objective of this project was to conduct a systematic review to (1) identify existing instruments for eHealth research and implementation evaluation from the patient's point of view, (2) characterize measurement components, and (3) assess psychometrics. Concepts from existing models and published studies of technology use and adoption were identified and used to inform a search strategy. Search terms were broadly categorized as platforms (eg, email), measurement (eg, survey), function/information use (eg, self-management), health care occupations (eg, nurse), and eHealth/telemedicine (eg, mHealth). A computerized database search was conducted through June 2014. Included articles (1) described development of an instrument, or (2) used an instrument that could be traced back to its original publication, or (3) modified an instrument, and (4) with full text in English language, and (5) focused on the patient perspective on technology, including patient preferences and satisfaction, engagement with technology, usability, competency and fluency with technology, computer literacy, and trust in and acceptance of technology. The review was limited to instruments that reported at least one psychometric property. Excluded were investigator-developed measures, disease-specific assessments delivered via technology or telephone (eg, a cancer-coping measure delivered via computer survey), and measures focused primarily on clinician use (eg, the electronic health record). The search strategy yielded 47,320 articles. Following elimination of duplicates and non

  7. Systematic literature reviews and meta-analyses: part 6 of a series on evaluation of scientific publications.

    Science.gov (United States)

    Ressing, Meike; Blettner, Maria; Klug, Stefanie J

    2009-07-01

    Because of the rising number of scientific publications, it is important to have a means of jointly summarizing and assessing different studies on a single topic. Systematic literature reviews, meta-analyses of published data, and meta-analyses of individual data (pooled reanalyses) are now being published with increasing frequency. We here describe the essential features of these methods and discuss their strengths and weaknesses. This article is based on a selective literature search. The different types of review and meta-analysis are described, the methods used in each are outlined so that they can be evaluated, and a checklist is given for the assessment of reviews and meta-analyses of scientific articles. Systematic literature reviews provide an overview of the state of research on a given topic and enable an assessment of the quality of individual studies. They also allow the results of different studies to be evaluated together when these are inconsistent. Meta-analyses additionally allow calculation of pooled estimates of an effect. The different types of review and meta-analysis are discussed with examples from the literature on one particular topic. Systematic literature reviews and meta-analyses enable the research findings and treatment effects obtained in different individual studies to be summed up and evaluated.

  8. Evaluating psychological markers for human nicotine dependence: tobacco choice, extinction, and Pavlovian-to-instrumental transfer.

    Science.gov (United States)

    Hogarth, Lee; Chase, Henry W

    2012-06-01

    Individual differences in drug dependence may be mediated by several abnormalities in associative learning, including perseveration of drug-seeking following contingency change, greater control over drug-seeking by Pavlovian stimuli, or greater sensitivity to drug reinforcement establishing higher rates of drug-seeking. To evaluate these three candidate markers for nicotine dependence, Experiment 1 contrasted daily (N = 22) and nondaily smoker groups (N = 22) on a novel instrumental learning task, where one S+ was first trained as a predictor of tobacco reward before being extinguished. Experiment 2 compared daily (N = 18) and nondaily smoker groups (N = 18) on a concurrent-choice task for tobacco and chocolate reward before an extinction test in which the tobacco response was extinguished, followed by a Pavlovian-to-instrumental transfer test, wherein the impact of tobacco and chocolate cues on concurrent choice was measured (gender was balanced within each smoker group). The results showed no group difference in sensitivity to extinction of either the stimulus-drug or response-drug contingency in Experiments 1 and 2, respectively, nor did groups show a difference in Pavlovian-to-instrumental transfer of control over tobacco choice. By contrast, nicotine-dependence status was marked by a higher frequency of tobacco choice in the concurrent-choice procedure, and this choice preference was associated with subjective craving (gender did not affect any behavioral measure). These results favor the view that nicotine dependence in this sample is not determined by individual predilection for perseveration or stimulus-control over drug-seeking, but by greater sensitivity to reinforcement of instrumental drug choice. Value-based decision theories of dependence are discussed.

  9. R-IDEAL: A Framework for Systematic Clinical Evaluation of Technical Innovations in Radiation Oncology.

    Science.gov (United States)

    Verkooijen, Helena M; Kerkmeijer, Linda G W; Fuller, Clifton D; Huddart, Robbert; Faivre-Finn, Corinne; Verheij, Marcel; Mook, Stella; Sahgal, Arjun; Hall, Emma; Schultz, Chris

    2017-01-01

    The pace of innovation in radiation oncology is high and the window of opportunity for evaluation narrow. Financial incentives, industry pressure, and patients' demand for high-tech treatments have led to widespread implementation of innovations before, or even without, robust evidence of improved outcomes has been generated. The standard phase I-IV framework for drug evaluation is not the most efficient and desirable framework for assessment of technological innovations. In order to provide a standard assessment methodology for clinical evaluation of innovations in radiotherapy, we adapted the surgical IDEAL framework to fit the radiation oncology setting. Like surgery, clinical evaluation of innovations in radiation oncology is complicated by continuous technical development, team and operator dependence, and differences in quality control. Contrary to surgery, radiotherapy innovations may be used in various ways, e.g., at different tumor sites and with different aims, such as radiation volume reduction and dose escalation. Also, the effect of radiation treatment can be modeled, allowing better prediction of potential benefits and improved patient selection. Key distinctive features of R-IDEAL include the important role of predicate and modeling studies (Stage 0), randomization at an early stage in the development of the technology, and long-term follow-up for late toxicity. We implemented R-IDEAL for clinical evaluation of a recent innovation in radiation oncology, the MRI-guided linear accelerator (MR-Linac). MR-Linac combines a radiotherapy linear accelerator with a 1.5-T MRI, aiming for improved targeting, dose escalation, and margin reduction, and is expected to increase the use of hypofractionation, improve tumor control, leading to higher cure rates and less toxicity. An international consortium, with participants from seven large cancer institutes from Europe and North America, has adopted the R-IDEAL framework to work toward coordinated, evidence

  10. Economic evaluation of HIV pre-exposure prophylaxis strategies: protocol for a methodological systematic review and quantitative synthesis.

    Science.gov (United States)

    Thavorn, Kednapa; Kugathasan, Howsikan; Tan, Darrell H S; Moqueet, Nasheed; Baral, Stefan D; Skidmore, Becky; MacFadden, Derek; Simkin, Anna; Mishra, Sharmistha

    2018-03-15

    Pre-exposure prophylaxis (PrEP) with antiretrovirals is an efficacious and effective intervention to decrease the risk of HIV (human immunodeficiency virus) acquisition. Yet drug and delivery costs prohibit access in many jurisdictions. In the absence of guidelines for the synthesis of economic evaluations, we developed a protocol for a systematic review of economic evaluation studies for PrEP by drawing on best practices in systematic reviews and the conduct and reporting of economic evaluations. We aim to estimate the incremental cost per health outcome of PrEP compared with placebo, no PrEP, or other HIV prevention strategies; assess the methodological variability in, and quality of, economic evaluations of PrEP; estimate the incremental cost per health outcome of different PrEP implementation strategies; and quantify the potential sources of heterogeneity in outcomes. We will systematically search electronic databases (MEDLINE, Embase) and the gray literature. We will include economic evaluation studies that assess both costs and health outcomes of PrEP in HIV-uninfected individuals, without restricting language or year of publication. Two reviewers will independently screen studies using predefined inclusion criteria, extract data, and assess methodological quality using the Philips checklist, Second Panel on the Cost-effectiveness of Health and Medicines, and the International Society for Pharmacoeconomics and Outcomes Research recommendations. Outcomes of interest include incremental costs and outcomes in natural units or utilities, cost-effectiveness ratios, and net monetary benefit. We will perform descriptive and quantitative syntheses using sensitivity analyses of outcomes by population subgroups, HIV epidemic settings, study designs, baseline intervention contexts, key parameter inputs and assumptions, type of outcomes, economic perspectives, and willingness to pay values. Findings will guide future economic evaluation of PrEP strategies in terms of

  11. Large variation in measures used to assess outcomes of opioid dependence treatment: A systematic review of longitudinal observational studies.

    Science.gov (United States)

    Wiessing, Lucas; Ferri, Marica; Darke, Shane; Simon, Roland; Griffiths, Paul

    2017-10-02

    Treatment outcomes for drug users are critical for informing policy and therapeutic practice. The coherence of outcomes, changes and drug use measures from observational studies on opioid use treatment were reviewed. Systematic review of the literature for longitudinal observational studies, from 1980 through November 2015, in all languages, with data on treated opioid users, using Pubmed, the Cochrane Library and additional strategies (e.g. Pubmed function 'related citations' and checking reference lists of eligible studies). Twenty-seven studies were included (11 countries, 85 publications, recruitment 1962-2009). Baseline n was >65 686 and median follow-up 34.5 months (21 studies) or 51.4 person-months (10 studies). Eight outcome domains were identified: 'drug use' (21/27 studies), 'crime' (13), 'health' (13), 'treatment-related' outcomes (16), 'social functioning' (13), 'harms' (8), 'mortality' (13) and 'economic estimates' (2 studies). All studies using drug use outcomes included a binary (abstinence) category in at least one measure. Studies typically reported outcomes on less than half (on average 3.7 or 46%) of the eight outcome domains, while the average was 5.1 (64%) in seven studies initiated since 2000. Wide variation exists in outcome measures found in longitudinal observational studies of treatment of opioid users. This reduces replicability of studies and suggests a lack of common expectations on treatment success. Future studies should consider using all or most of eight outcome domains identified (excluding economic analyses if unfeasible), non-binary measures and amount/value of drugs used and consensus meetings with joint ownership of scientific, treatment and patient communities. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  12. Diagnostic tests and algorithms used in the investigation of haematuria: systematic reviews and economic evaluation.

    Science.gov (United States)

    Rodgers, M; Nixon, J; Hempel, S; Aho, T; Kelly, J; Neal, D; Duffy, S; Ritchie, G; Kleijnen, J; Westwood, M

    2006-06-01

    To determine the most effective diagnostic strategy for the investigation of microscopic and macroscopic haematuria in adults. Electronic databases from inception to October 2003, updated in August 2004. A systematic review was undertaken according to published guidelines. Decision analytic modelling was undertaken, based on the findings of the review, expert opinion and additional information from the literature, to assess the relative cost-effectiveness of plausible alternative tests that are part of diagnostic algorithms for haematuria. A total of 118 studies met the inclusion criteria. No studies that evaluated the effectiveness of diagnostic algorithms for haematuria or the effectiveness of screening for haematuria or investigating its underlying cause were identified. Eighteen out of 19 identified studies evaluated dipstick tests and data from these suggested that these are moderately useful in establishing the presence of, but cannot be used to rule out, haematuria. Six studies using haematuria as a test for the presence of a disease indicated that the detection of microhaematuria cannot alone be considered a useful test either to rule in or rule out the presence of a significant underlying pathology (urinary calculi or bladder cancer). Forty-eight of 80 studies addressed methods to localise the source of bleeding (renal or lower urinary tract). The methods and thresholds described in these studies varied greatly, precluding any estimate of a 'best performance' threshold that could be applied across patient groups. However, studies of red blood cell morphology that used a cut-off value of 80% dysmorphic cells for glomerular disease reported consistently high specificities (potentially useful in ruling in a renal cause for haematuria). The reported sensitivities were generally low. Twenty-eight studies included data on the accuracy of laboratory tests (tumour markers, cytology) for the diagnosis of bladder cancer. The majority of tumour marker studies

  13. [Taking evaluation of post-marketing as point of cut-in to promote systematic research of traditional Chinese medicine].

    Science.gov (United States)

    Wang, Yong-yan; Wang, Zhi-fei; Xie, Yan-ming

    2014-09-01

    Research on post-marketing Chinese medicine should be the systematic study from application to mechanism. Clinical evaluation is the basis of mechanism study, we can find the clue from clinical evaluation, then make a mechanism study to find the reason, then apply the results to clinic. So it is a virtuous circle. In order to achieve it, we cannot be limited to traditional Chinese medicine, we should form multi-disciplinary team under the direction of grand science thinking, try hard to put industry-university-research institute collaboration association to use, and if necessary, explore the new model of the whole nation system. An appropriate operation mechanism is very important.

  14. A comparison between Markovian models and Bayesian networks for treating some dependent events in reliability evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Duarte, Juliana P.; Leite, Victor C.; Melo, P.F. Frutuoso e, E-mail: julianapduarte@poli.ufrj.br, E-mail: victor.coppo.leite@poli.ufrj.br, E-mail: frutuoso@nuclear.ufrj.br [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil)

    2013-07-01

    Bayesian networks have become a very handy tool for solving problems in various application areas. This paper discusses the use of Bayesian networks to treat dependent events in reliability engineering typically modeled by Markovian models. Dependent events play an important role as, for example, when treating load-sharing systems, bridge systems, common-cause failures, and switching systems (those for which a standby component is activated after the main one fails by means of a switching mechanism). Repair plays an important role in all these cases (as, for example, the number of repairmen). All Bayesian network calculations are performed by means of the Netica™ software, of Norsys Software Corporation, and Fortran 90 to evaluate them over time. The discussion considers the development of time-dependent reliability figures of merit, which are easily obtained, through Markovian models, but not through Bayesian networks, because these latter need probability figures as input and not failure and repair rates. Bayesian networks produced results in very good agreement with those of Markov models and pivotal decomposition. Static and discrete time (DTBN) Bayesian networks were used in order to check their capabilities of modeling specific situations, like switching failures in cold-standby systems. The DTBN was more flexible to modeling systems where the time of occurrence of an event is important, for example, standby failure and repair. However, the static network model showed as good results as DTBN by a much more simplified approach. (author)

  15. A comparison between Markovian models and Bayesian networks for treating some dependent events in reliability evaluations

    International Nuclear Information System (INIS)

    Duarte, Juliana P.; Leite, Victor C.; Melo, P.F. Frutuoso e

    2013-01-01

    Bayesian networks have become a very handy tool for solving problems in various application areas. This paper discusses the use of Bayesian networks to treat dependent events in reliability engineering typically modeled by Markovian models. Dependent events play an important role as, for example, when treating load-sharing systems, bridge systems, common-cause failures, and switching systems (those for which a standby component is activated after the main one fails by means of a switching mechanism). Repair plays an important role in all these cases (as, for example, the number of repairmen). All Bayesian network calculations are performed by means of the Netica™ software, of Norsys Software Corporation, and Fortran 90 to evaluate them over time. The discussion considers the development of time-dependent reliability figures of merit, which are easily obtained, through Markovian models, but not through Bayesian networks, because these latter need probability figures as input and not failure and repair rates. Bayesian networks produced results in very good agreement with those of Markov models and pivotal decomposition. Static and discrete time (DTBN) Bayesian networks were used in order to check their capabilities of modeling specific situations, like switching failures in cold-standby systems. The DTBN was more flexible to modeling systems where the time of occurrence of an event is important, for example, standby failure and repair. However, the static network model showed as good results as DTBN by a much more simplified approach. (author)

  16. Guideline for Performing Systematic Approach to Evaluate and Qualify Legacy Documents that Support Advanced Reactor Technology Activity

    International Nuclear Information System (INIS)

    Honma, George

    2015-01-01

    The establishment of a systematic process for the evaluation of historic technology information for use in advanced reactor licensing is described. Efforts are underway to recover and preserve Experimental Breeder Reactor II and Fast Flux Test Facility historical data. These efforts have generally emphasized preserving information from data-acquisition systems and hard-copy reports and entering it into modern electronic formats suitable for data retrieval and examination. The guidance contained in this document has been developed to facilitate consistent and systematic evaluation processes relating to quality attributes of historic technical information (with focus on sodium-cooled fast reactor (SFR) technology) that will be used to eventually support licensing of advanced reactor designs. The historical information may include, but is not limited to, design documents for SFRs, research-and-development (R&D) data and associated documents, test plans and associated protocols, operations and test data, international research data, technical reports, and information associated with past U.S. Nuclear Regulatory Commission (NRC) reviews of SFR designs. The evaluation process is prescribed in terms of SFR technology, but the process can be used to evaluate historical information for any type of advanced reactor technology. An appendix provides a discussion of typical issues that should be considered when evaluating and qualifying historical information for advanced reactor technology fuel and source terms, based on current light water reactor (LWR) requirements and recent experience gained from Next Generation Nuclear Plant (NGNP).

  17. Guideline for Performing Systematic Approach to Evaluate and Qualify Legacy Documents that Support Advanced Reactor Technology Activity

    Energy Technology Data Exchange (ETDEWEB)

    Honma, George [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-10-01

    The establishment of a systematic process for the evaluation of historic technology information for use in advanced reactor licensing is described. Efforts are underway to recover and preserve Experimental Breeder Reactor II and Fast Flux Test Facility historical data. These efforts have generally emphasized preserving information from data-acquisition systems and hard-copy reports and entering it into modern electronic formats suitable for data retrieval and examination. The guidance contained in this document has been developed to facilitate consistent and systematic evaluation processes relating to quality attributes of historic technical information (with focus on sodium-cooled fast reactor (SFR) technology) that will be used to eventually support licensing of advanced reactor designs. The historical information may include, but is not limited to, design documents for SFRs, research-and-development (R&D) data and associated documents, test plans and associated protocols, operations and test data, international research data, technical reports, and information associated with past U.S. Nuclear Regulatory Commission (NRC) reviews of SFR designs. The evaluation process is prescribed in terms of SFR technology, but the process can be used to evaluate historical information for any type of advanced reactor technology. An appendix provides a discussion of typical issues that should be considered when evaluating and qualifying historical information for advanced reactor technology fuel and source terms, based on current light water reactor (LWR) requirements and recent experience gained from Next Generation Nuclear Plant (NGNP).

  18. Systematic review of ERP and fMRI studies investigating inhibitory control and error processing in people with substance dependence and behavioural addictions

    NARCIS (Netherlands)

    Luijten, M.; Machielsen, M.W.J.; Veltman, D.J.; Hester, R.; de Haan, L.; Franken, I.H.A.

    2014-01-01

    Background: Several current theories emphasize the role of cognitive control in addiction. The present review evaluates neural deficits in the domains of inhibitory control and error processing in individuals with substance dependence and in those showing excessive addiction-like behaviours. The

  19. Systematic review of ERP and fMRI studies investigating inhibitory control and error processing in people with substance dependence and behavioural addictions

    NARCIS (Netherlands)

    Luijten, Maartje; Machielsen, Marise W. J.; Veltman, Dick J.; Hester, Robert; de Haan, Lieuwe; Franken, Ingmar H. A.

    2014-01-01

    Several current theories emphasize the role of cognitive control in addiction. The present review evaluates neural deficits in the domains of inhibitory control and error processing in individuals with substance dependence and in those showing excessive addiction-like behaviours. The combined

  20. What are the barriers and facilitators for third sector organisations (non-profits) to evaluate their services? A systematic review.

    Science.gov (United States)

    Bach-Mortensen, Anders Malthe; Montgomery, Paul

    2018-01-22

    The third sector is becoming a more common provider of social and health services, but little is known about how third sector organisations (TSOs) evaluate their activities. Past research has reported that the third sector is under increasing pressure to evaluate its impact and performance by government and other commissioning bodies. However, in responding to this increased pressure to undertake evaluation, research suggests that many TSOs struggle to evaluate their activities following the principles of evidence-based practice (EBP). Yet, there has been no systematic effort to investigate why the third sector is struggling to provide good quality evidence of its effects. This systematic review is reported following the PRISMA guidelines. Ten interdisciplinary databases were searched using a search string developed following best practice and in consultation with an information systems expert. Included studies were primary research of any research design investigating barriers to and facilitators of the evaluation process of TSOs as identified by practitioners. All studies were quality appraised, and the results were synthesised as a thematic summary. Twenty-four studies were included, which mainly investigated TSOs working within health and social services. The thematic summary identified the main barriers for TSOs to undertake evaluation to be related to the (1) lack of financial resources, (2) lack of technical capability and evaluation literacy and (3) challenges around identifying relevant evaluation systems and outcome indicators. Key facilitating factors involved (1) getting the appropriate support, (2) having an organisational culture that supports evaluation and (3) the motivation to be accountable to stakeholders. These findings were robust to study quality. This review constitutes the first systematic effort to synthesise existing literature on factors supporting and preventing evaluation by TSOs. The prevalence of factors revolving around the lack of

  1. Systematic study of the spin stiffness dependence on phosphorus alloying in the ferromagnetic semiconductor (Ga,Mn)As

    International Nuclear Information System (INIS)

    Shihab, S.; Thevenard, L.; Bardeleben, H. J. von; Gourdon, C.; Riahi, H.; Lemaître, A.

    2015-01-01

    We study the dependence of the spin stiffness constant on the phosphorus concentration in the ferromagnetic semiconductor (Ga,Mn)(As,P) with the aim of determining whether alloying with phosphorus is detrimental, neutral, or advantageous to the spin stiffness. Time-resolved magneto-optical experiments are carried out in thin epilayers. Laser pulses excite two perpendicular standing spin wave modes, which are exchange related. We show that the first mode is spatially uniform across the layer corresponding to a k≈0 wavevector. From the two frequencies and k-vector spacings we obtain the spin stiffness constant for different phosphorus concentrations using weak surface pinning conditions. The mode assessment is checked by comparison to the spin stiffness obtained from domain pattern analysis for samples with out-of-plane magnetization. The spin stiffness is found to exhibit little variation with phosphorus concentration in contradiction with ab-initio predictions

  2. Systematic Evaluation of Pleiotropy Identifies 6 Further Loci Associated With Coronary Artery Disease

    NARCIS (Netherlands)

    Webb, Thomas R.; Erdmann, Jeanette; Stirrups, Kathleen E.; Stitziel, Nathan O.; Masca, Nicholas G. D.; Jansen, Henning; Kanoni, Stavroula; Nelson, Christopher P.; Ferrario, Paola G.; König, Inke R.; Eicher, John D.; Johnson, Andrew D.; Hamby, Stephen E.; Betsholtz, Christer; Ruusalepp, Arno; Franzén, Oscar; Schadt, Eric E.; Björkegren, Johan L. M.; Weeke, Peter E.; Auer, Paul L.; Schick, Ursula M.; Lu, Yingchang; Zhang, He; Dube, Marie-Pierre; Goel, Anuj; Farrall, Martin; Peloso, Gina M.; Won, Hong-Hee; Do, Ron; van Iperen, Erik; Kruppa, Jochen; Mahajan, Anubha; Scott, Robert A.; Willenborg, Christina; Braund, Peter S.; van Capelleveen, Julian C.; Doney, Alex S. F.; Donnelly, Louise A.; Asselta, Rosanna; Merlini, Pier A.; Duga, Stefano; Marziliano, Nicola; Denny, Josh C.; Shaffer, Christian; El-Mokhtari, Nour Eddine; Franke, Andre; Heilmann, Stefanie; Hengstenberg, Christian; Hoffmann, Per; Holmen, Oddgeir L.; Hveem, Kristian; Jansson, Jan-Håkan; Jöckel, Karl-Heinz; Kessler, Thorsten; Kriebel, Jennifer; Laugwitz, Karl L.; Marouli, Eirini; Martinelli, Nicola; McCarthy, Mark I.; van Zuydam, Natalie R.; Meisinger, Christa; Esko, Tõnu; Mihailov, Evelin; Escher, Stefan A.; Alver, Maris; Moebus, Susanne; Morris, Andrew D.; Virtamo, Jarma; Nikpay, Majid; Olivieri, Oliviero; Provost, Sylvie; AlQarawi, Alaa; Robertson, Neil R.; Akinsansya, Karen O.; Reilly, Dermot F.; Vogt, Thomas F.; Yin, Wu; Asselbergs, Folkert W.; Kooperberg, Charles; Jackson, Rebecca D.; Stahl, Eli; Müller-Nurasyid, Martina; Strauch, Konstantin; Varga, Tibor V.; Waldenberger, Melanie; Zeng, Lingyao; Chowdhury, Rajiv; Salomaa, Veikko; Ford, Ian; Jukema, J. Wouter; Amouyel, Philippe; Kontto, Jukka; Nordestgaard, Børge G.; Ferrières, Jean; Saleheen, Danish; Sattar, Naveed; Surendran, Praveen; Wagner, Aline; Young, Robin; Howson, Joanna M. M.; Butterworth, Adam S.; Danesh, John; Ardissino, Diego; Bottinger, Erwin P.; Erbel, Raimund; Franks, Paul W.; Girelli, Domenico; Hall, Alistair S.; Hovingh, G. Kees; Kastrati, Adnan; Lieb, Wolfgang; Meitinger, Thomas; Kraus, William E.; Shah, Svati H.; McPherson, Ruth; Orho-Melander, Marju; Melander, Olle; Metspalu, Andres; Palmer, Colin N. A.; Peters, Annette; Rader, Daniel J.; Reilly, Muredach P.; Loos, Ruth J. F.; Reiner, Alex P.; Roden, Dan M.; Tardif, Jean-Claude; Thompson, John R.; Wareham, Nicholas J.; Watkins, Hugh; Willer, Cristen J.; Samani, Nilesh J.; Schunkert, Heribert; Deloukas, Panos; Kathiresan, Sekar

    2017-01-01

    Genome-wide association studies have so far identified 56 loci associated with risk of coronary artery disease (CAD). Many CAD loci show pleiotropy; that is, they are also associated with other diseases or traits. This study sought to systematically test if genetic variants identified for non-CAD

  3. A systematic review of studies evaluating Australian indigenous community development projects

    NARCIS (Netherlands)

    Snijder, Mieke; Shakeshaft, Anthony; Wagemakers, Annemarie; Stephens, Anne; Calabria, Bianca

    2015-01-01

    Background: Community development is a health promotion approach identified as having great potential to improve Indigenous health, because of its potential for extensive community participation. There has been no systematic examination of the extent of community participation in community

  4. Patient autonomy problems in palliative care: systematic development and evaluation of a questionnaire.

    NARCIS (Netherlands)

    Vernooy-Dassen, M.J.F.J.; Osse, B.H.P.; Schade, E.; Grol, R.P.T.M.

    2005-01-01

    No instrument to assess autonomy problems in palliative care is currently available. The purpose of this study was to develop a comprehensive and concise questionnaire to measure autonomy problems in palliative cancer patients and to study its validity and reliability. We systematically developed a

  5. Magnetic resonance imaging for evaluation of disease activity in Crohn's disease: a systematic review

    NARCIS (Netherlands)

    Horsthuis, Karin; Bipat, Shandra; Stokkers, Pieter C. F.; Stoker, Jaap

    2009-01-01

    To systematically review the evidence on the accuracy of MRI for grading disease activity in Crohn's disease (CD). The MEDLINE, EMBASE, CINAHL and Cochrane databases were searched for studies on the accuracy of MRI in grading CD compared to a predefined reference standard. Two independent observers

  6. Fit-for-purpose: species distribution model performance depends on evaluation criteria - Dutch Hoverflies as a case study.

    Science.gov (United States)

    Aguirre-Gutiérrez, Jesús; Carvalheiro, Luísa G; Polce, Chiara; van Loon, E Emiel; Raes, Niels; Reemer, Menno; Biesmeijer, Jacobus C

    2013-01-01

    Understanding species distributions and the factors limiting them is an important topic in ecology and conservation, including in nature reserve selection and predicting climate change impacts. While Species Distribution Models (SDM) are the main tool used for these purposes, choosing the best SDM algorithm is not straightforward as these are plentiful and can be applied in many different ways. SDM are used mainly to gain insight in 1) overall species distributions, 2) their past-present-future probability of occurrence and/or 3) to understand their ecological niche limits (also referred to as ecological niche modelling). The fact that these three aims may require different models and outputs is, however, rarely considered and has not been evaluated consistently. Here we use data from a systematically sampled set of species occurrences to specifically test the performance of Species Distribution Models across several commonly used algorithms. Species range in distribution patterns from rare to common and from local to widespread. We compare overall model fit (representing species distribution), the accuracy of the predictions at multiple spatial scales, and the consistency in selection of environmental correlations all across multiple modelling runs. As expected, the choice of modelling algorithm determines model outcome. However, model quality depends not only on the algorithm, but also on the measure of model fit used and the scale at which it is used. Although model fit was higher for the consensus approach and Maxent, Maxent and GAM models were more consistent in estimating local occurrence, while RF and GBM showed higher consistency in environmental variables selection. Model outcomes diverged more for narrowly distributed species than for widespread species. We suggest that matching study aims with modelling approach is essential in Species Distribution Models, and provide suggestions how to do this for different modelling aims and species' data

  7. Evaluating the safety and immunogenicity of yellow fever vaccines: a systematic review

    Directory of Open Access Journals (Sweden)

    Thomas RE

    2015-04-01

    Full Text Available Roger E Thomas Department of Family Medicine, G012 Health Sciences Center, University of Calgary Medical School, Calgary, AB, Canada Purpose: To review the safety and immunogenicity of yellow fever vaccines. Literature search: The Cochrane Library (including the Cochrane CENTRAL Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and the NHS Database of Abstracts of Reviews of Effects; MEDLINE; EMBASE; BIOSIS Previews; Global Health; CAB Abstracts; and the Lilacs Database of Latin American and Caribbean literature were searched for individual studies and systematic reviews through January 1, 2015. Results: Six yellow fever vaccines are currently produced, and they are effective against all seven yellow fever virus strains. There is a 99.2% homology of the genome sequences of the six current vaccines. Four systematic reviews identified very small numbers of serious adverse events. A systematic review (updated of all published cases identified 133 serious adverse events that met the Brighton Collaboration criteria: 32 anaphylactic, 42 neurologic (one death, 57 viscerotropic (25 deaths, and two of both neurologic and viscerotropic SAEs. The Sanofi Pasteur Global Pharmacovigilance database reported 276 million doses of Stamaril™ distributed worldwide and identified 12 reports of yellow fever vaccine-associated viscerotropic disease (YEL-AVD, 24 of yellow fever vaccine-associated neurologic disease (YEL-AND, and 33 reports of anaphylaxis (many already published. The Biomanguinhos manufacturer's database reported 110 million doses distributed worldwide between 1999 and 2009, and the rate of YEL-AND was estimated at 0.084/100,000 doses distributed and YEL-AVD at 0.02/100,000 doses distributed. Conclusion: Reports of serious adverse events are mostly from travelers from developed countries, and there is likely serious underreporting for developing countries. On the basis of the published reports, the yellow fever vaccines are

  8. An Integrated Modeling Approach to Evaluate and Optimize Data Center Sustainability, Dependability and Cost

    Directory of Open Access Journals (Sweden)

    Gustavo Callou

    2014-01-01

    Full Text Available Data centers have evolved dramatically in recent years, due to the advent of social networking services, e-commerce and cloud computing. The conflicting requirements are the high availability levels demanded against the low sustainability impact and cost values. The approaches that evaluate and optimize these requirements are essential to support designers of data center architectures. Our work aims to propose an integrated approach to estimate and optimize these issues with the support of the developed environment, Mercury. Mercury is a tool for dependability, performance and energy flow evaluation. The tool supports reliability block diagrams (RBD, stochastic Petri nets (SPNs, continuous-time Markov chains (CTMC and energy flow (EFM models. The EFM verifies the energy flow on data center architectures, taking into account the energy efficiency and power capacity that each device can provide (assuming power systems or extract (considering cooling components. The EFM also estimates the sustainability impact and cost issues of data center architectures. Additionally, a methodology is also considered to support the modeling, evaluation and optimization processes. Two case studies are presented to illustrate the adopted methodology on data center power systems.

  9. Systematic Correlation Matrix Evaluation (SCoMaE) - a bottom-up, science-led approach to identifying indicators

    Science.gov (United States)

    Mengis, Nadine; Keller, David P.; Oschlies, Andreas

    2018-01-01

    This study introduces the Systematic Correlation Matrix Evaluation (SCoMaE) method, a bottom-up approach which combines expert judgment and statistical information to systematically select transparent, nonredundant indicators for a comprehensive assessment of the state of the Earth system. The methods consists of two basic steps: (1) the calculation of a correlation matrix among variables relevant for a given research question and (2) the systematic evaluation of the matrix, to identify clusters of variables with similar behavior and respective mutually independent indicators. Optional further analysis steps include (3) the interpretation of the identified clusters, enabling a learning effect from the selection of indicators, (4) testing the robustness of identified clusters with respect to changes in forcing or boundary conditions, (5) enabling a comparative assessment of varying scenarios by constructing and evaluating a common correlation matrix, and (6) the inclusion of expert judgment, for example, to prescribe indicators, to allow for considerations other than statistical consistency. The example application of the SCoMaE method to Earth system model output forced by different CO2 emission scenarios reveals the necessity of reevaluating indicators identified in a historical scenario simulation for an accurate assessment of an intermediate-high, as well as a business-as-usual, climate change scenario simulation. This necessity arises from changes in prevailing correlations in the Earth system under varying climate forcing. For a comparative assessment of the three climate change scenarios, we construct and evaluate a common correlation matrix, in which we identify robust correlations between variables across the three considered scenarios.

  10. A change in inflammatory footprint precedes plaque instability: a systematic evaluation of cellular aspects of the adaptive immune response in human atherosclerosis

    NARCIS (Netherlands)

    van Dijk, R. A.; Duinisveld, A. J. F.; Schaapherder, A. F.; Mulder-Stapel, A.; Hamming, J. F.; Kuiper, J.; de Boer, O. J.; van der Wal, A. C.; Kolodgie, F. D.; Virmani, R.; Lindeman, J. H. N.

    2015-01-01

    Experimental studies characterize adaptive immune response as a critical factor in the progression and complications of atherosclerosis. Yet, it is unclear whether these observations translate to the human situation. This study systematically evaluates cellular components of the adaptive immune

  11. The safety and effectiveness of different methods of earwax removal: a systematic review and economic evaluation.

    Science.gov (United States)

    Clegg, A J; Loveman, E; Gospodarevskaya, E; Harris, P; Bird, A; Bryant, J; Scott, D A; Davidson, P; Little, P; Coppin, R

    2010-06-01

    care (14 studies), secondary care (8 studies) or other care settings (4 studies), met the inclusion criteria for the review - 22 RCTs and 4 CCTs. The range of interventions included 16 different softeners, with or without irrigation, and in various different comparisons. Participants, outcomes, timing of intervention, follow-up and methodological quality varied between studies. On measures of wax clearance Cerumol, sodium bicarbonate, olive oil and water are all more effective than no treatment; triethanolamine polypeptide (TP) is better than olive oil; wet irrigation is better than dry irrigation; sodium bicarbonate drops followed by irrigation by nurse is more effective than sodium bicarbonate drops followed by self-irrigation; softening with TP and self-irrigation is more effective than self-irrigation only; and endoscopic de-waxing is better than microscopic de-waxing. AEs appeared to be minor and of limited extent. Resuts of the exploratory economic model found that softeners followed by self-irrigation were more likely to be cost-effective [24,433 pounds per quality-adjusted life-year (QALY)] than softeners followed by irrigation at primary care (32,130 pounds per QALY) when compared with no treatment. Comparison of the two active treatments showed that the additional gain associated with softeners followed by irrigation at primary care over softeners followed by self-irrigation was at a cost of 340,000 pounds per QALY. When compared over a lifetime horizon to the 'no treatment' option, the ICERs for softeners followed by self-irrigation and of softeners followed by irrigation at primary care were 24,450 pounds per QALY and 32,136 pounds per QALY, respectively. The systematic review found limited good-quality evidence of the safety, benefits and costs of the different strategies, making it difficult to differentiate between the various methods for removing earwax and rendering the economic evaluation as speculative. Although softeners are effective, which

  12. A Systematic Evaluation of Ultrasound-based Fetal Weight Estimation Models on Indian Population

    Directory of Open Access Journals (Sweden)

    Sujitkumar S. Hiwale

    2017-12-01

    Conclusion: We found that the existing fetal weight estimation models have high systematic and random errors on Indian population, with a general tendency of overestimation of fetal weight in the LBW category and underestimation in the HBW category. We also observed that these models have a limited ability to predict babies at a risk of either low or high birth weight. It is recommended that the clinicians should consider all these factors, while interpreting estimated weight given by the existing models.

  13. Environmental scan and evaluation of best practices for online systematic review resources

    Directory of Open Access Journals (Sweden)

    Robin M. N. Parker

    2018-04-01

    Conclusion: This study revealed that resources include appropriate content but are less likely to adhere to principles of online training design and interactivity. Awareness of these resources will allow librarians to make informed recommendations for training based on patrons’ needs. Future online systematic review training resources should use established best practices for e-learning to provide high-quality resources, regardless of format or user time commitment.

  14. Instruments evaluating the quality of the clinical learning environment in nursing education: A systematic review of psychometric properties.

    Science.gov (United States)

    Mansutti, Irene; Saiani, Luisa; Grassetti, Luca; Palese, Alvisa

    2017-03-01

    The clinical learning environment is fundamental to nursing education paths, capable of affecting learning processes and outcomes. Several instruments have been developed in nursing education, aimed at evaluating the quality of the clinical learning environments; however, no systematic review of the psychometric properties and methodological quality of these studies has been performed to date. The aims of the study were: 1) to identify validated instruments evaluating the clinical learning environments in nursing education; 2) to evaluate critically the methodological quality of the psychometric property estimation used; and 3) to compare psychometric properties across the instruments available. A systematic review of the literature (using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines) and an evaluation of the methodological quality of psychometric properties (using the COnsensus-based Standards for the selection of health Measurement INstruments guidelines). The Medline and CINAHL databases were searched. Eligible studies were those that satisfied the following criteria: a) validation studies of instruments evaluating the quality of clinical learning environments; b) in nursing education; c) published in English or Italian; d) before April 2016. The included studies were evaluated for the methodological quality of the psychometric properties measured and then compared in terms of both the psychometric properties and the methodological quality of the processes used. The search strategy yielded a total of 26 studies and eight clinical learning environment evaluation instruments. A variety of psychometric properties have been estimated for each instrument, with differing qualities in the methodology used. Concept and construct validity were poorly assessed in terms of their significance and rarely judged by the target population (nursing students). Some properties were rarely considered (e.g., reliability, measurement error

  15. Clinical effectiveness and cost-effectiveness of laparoscopic surgery for colorectal cancer: systematic reviews and economic evaluation.

    Science.gov (United States)

    Murray, A; Lourenco, T; de Verteuil, R; Hernandez, R; Fraser, C; McKinley, A; Krukowski, Z; Vale, L; Grant, A

    2006-11-01

    The aim of this study was to determine the clinical effectiveness and cost-effectiveness of laparoscopic, laparoscopically assisted (hereafter together described as laparoscopic surgery) and hand-assisted laparoscopic surgery (HALS) in comparison with open surgery for the treatment of colorectal cancer. Electronic databases were searched from 2000 to May 2005. A review of economic evaluations was undertaken by the National Institute for Health and Clinical Excellence in 2001. This review was updated from 2000 until July 2005. Data from selected studies were extracted and assessed. Dichotomous outcome data from individual trials were combined using the relative risk method and continuous outcomes were combined using the Mantel-Haenszel weighted mean difference method. Summaries of the results from individual patient data (IPD) meta-analyses were also presented. An economic evaluation was also carried out using a Markov model incorporating the data from the systematic review. The results were first presented as a balance sheet for comparison of the surgical techniques. It was then used to estimate cost-effectiveness measured in terms of incremental cost per life-year gained and incremental cost per quality-adjusted life-year (QALY) for a time horizon up to 25 years. Forty-six reports on 20 studies [19 randomised controlled trials (RCTs) and one IPD meta-analysis] were included in the review of clinical effectiveness. The RCTs were of generally moderate quality with the number of participants varying between 16 and 1082, with 10 having less than 100 participants. The total numbers of trial participants who underwent laparoscopic or open surgery were 2429 and 2139, respectively. A systematic review of four papers suggested that laparoscopic surgery is more costly than open surgery. However, the data they provided on effectiveness was poorer than the evidence from the review of effectiveness. The estimates from the systematic review of clinical effectiveness were

  16. Evaluating the time-dependent and bond characteristics of lightweight concrete mixes for Kansas prestressed concrete bridges.

    Science.gov (United States)

    2011-07-01

    This report details results from testing that was conducted to determine the bond and time-dependent : characteristics of two lightweight concrete mixes. The lightweight mixes were evaluated to possibly : provide a more cost-effective solution to rep...

  17. The global chemical systematics of arc front stratovolcanoes: Evaluating the role of crustal processes

    Science.gov (United States)

    Turner, Stephen J.; Langmuir, Charles H.

    2015-07-01

    Petrogenetic models for convergent margins should be consistent with the global systematics of convergent margin volcanic compositions. A newly developed tool for compiling and screening data from the GEOROC database was used to generate a global dataset of whole rock chemical analyses from arc front stratovolcano samples. Data from 227 volcanoes within 31 volcanic arc segments were first averaged by volcano and then by arc to explore global systematics. Three different methods of data normalization produce consistent results that persist across a wide range of Mg# [Mg# =Mg / (Mg +Fe) ]. Remarkably coherent systematics are present among major and trace element concentrations and ratios, with the exception of three arcs influenced by mantle plumes and Peru/N. Chile, which is built on exceptionally thick crust. Chemical parameters also correlate with the thickness of the overlying arc crust. In addition to previously established correlations of Na6.0 with Ca6.0 and crustal thickness, correlations are observed among major elements, trace elements, and trace element ratios (e.g. La/Yb, Dy/Yb, Zr/Sm, Zr/Ti). Positive correlations include "fluid mobile," "high field strength," and "large ion lithophile" element groups, with concentrations that vary by a factor of five in all groups. Incompatible element enrichments also correlate well with crustal thickness, with the greatest enrichment found at arcs with the thickest crust. Intra-crustal processes, however, do not reproduce the global variations. High pressure fractionation produces intermediate magmas enriched in aluminum, but such magmas are rare. Furthermore, differences among magma compositions at various volcanic arcs persist from primitive to evolved compositions, which is inconsistent with the possibility that global variations are produced by crystal fractionation at any pressure. Linear relationships among elements appear to be consistent with mixing between depleted primary magma and an enriched contaminant

  18. Systematic review and metaanalysis of statins for heterozygous familial hypercholesterolemia in children: evaluation of cholesterol changes and side effects.

    LENUS (Irish Health Repository)

    O'Gorman, Clodagh S

    2012-02-01

    Heterozygous familial hypercholesterolemia (heFH) affects 1 in 500 individuals. Evidence supports the low-density lipoprotein (LDL)-lowering effect of statins for adults with heFH. However, there are concerns regarding the treatment children with heFH. By performing a systematic review and metaanalysis of the published literature, this study aimed to evaluate the efficacy and safety of statins used for children with heFH. A systematic review was performed by searching multiple medical databases and citations to identify reports of randomized controlled trials of statins used to treat children with heFH. The trials were retrieved, reviewed, and subjected to metaanalysis. The search yielded 2,174 titles. Of the 63 studies retrieved and reviewed, 56 were excluded, 7 were included in the systematic review, and 4 were included in the metaanalysis. Significant heterogeneity was detected. The metaanalysis showed significant LDL lowering, high-density lipoprotein (HDL) cholesterol elevation, and increases in height and weight with statins. The metaanalysis could not be performed for many side effects of statins, but individual trials showed no significant side effects. Quality assessment showed methodologic concerns, with potential for bias. For example, six trials analyzed statin effects without intention to treat despite such a stated intention. Metaanalysis shows significant LDL lowering with statin treatment. Further studies, including epidemiologic and multicenter studies, are required.

  19. Integrated plant-safety assessment, Systematic Evaluation Program: Big Rock Point Plant (Docket No. 50-155)

    International Nuclear Information System (INIS)

    1983-09-01

    The Systematic Evaluation Program was initiated in February 1977 by the US Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to reconfirm and document their safety. This report documents the review of the Big Rock Point Plant, which is one of ten plants reviewed under Phase II of this program. This report indicates how 137 topics selected for review under Phase I of the program were addressed. It also addresses a majority of the pending licensing actions for Big Rock Point, which include TMI Action Plan requirements and implementation criteria for resolved generic issues. Equipment and procedural changes have been identified as a result of the review

  20. Systematic Evaluation of Desmopressin Applied to the Patients with Aneurysmal Subarachnoid Haemorrhage in the light of the Literature.

    Science.gov (United States)

    Karaarslan, Numan; Yilmaz, Ibrahim; Akgun, Feride Sinem; Caliskan, Tezcan; Ozbek, Hanefi; Ates, Ozkan

    2018-04-09

    This study discusses the management of patients with the syndrome of inappropriate antidiuretic hormone secretion (SIADH), developed after subarachnoid hemorrhage, in a comparative manner in light of the literature. Without country or language restrictions, articles with high evidential value found in electronic databases were compared to our patients' data. After the literature review, three articles were included for systematic evaluation. Desmopressin was applied to the patients for the treatment of hyponatremia, volume contraction, and negative sodium balance caused by SIADH. However, it was not used for preventing re-bleeding. To prevent the development of this complication (SIADH), the use of desmopressin, an analogue of vasopressin, is important in routine clinical practice.

  1. An evaluation of a model for the systematic documentation of hospital based health promotion activities: results from a multicentre study

    Directory of Open Access Journals (Sweden)

    Morris Denise

    2007-09-01

    Full Text Available Abstract Background The first step of handling health promotion (HP in Diagnosis Related Groups (DRGs is a systematic documentation and registration of the activities in the medical records. So far the possibility and tradition for systematic registration of clinical HP activities in the medical records and in patient administrative systems have been sparse. Therefore, the activities are mostly invisible in the registers of hospital services as well as in budgets and balances. A simple model has been described to structure the registration of the HP procedures performed by the clinical staff. The model consists of two parts; first part includes motivational counselling (7 codes and the second part comprehends intervention, rehabilitation and after treatment (8 codes. The objective was to evaluate in an international study the usefulness, applicability and sufficiency of a simple model for the systematic registration of clinical HP procedures in day life. Methods The multi centre project was carried out in 19 departments/hospitals in 6 countries in a clinical setup. The study consisted of three parts in accordance with the objectives. A: Individual test. 20 consecutive medical records from each participating department/hospital were coded by the (coding specialists at local department/hospital, exclusively (n = 5,529 of 5,700 possible tests in total. B: Common test. 14 standardized medical records were coded by all the specialists from 17 departments/hospitals, who returned 3,046 of 3,570 tests. C: Specialist evaluation. The specialists from the 19 departments/hospitals evaluated if the codes were useful, applicable and sufficient for the registration in their own department/hospital (239 of 285. Results A: In 97 to100% of the local patient pathways the specialists were able to evaluate if there was documentation of HP activities in the medical record to be coded. B: Inter rater reliability on the use of the codes were 93% (57 to 100% and 71% (31

  2. Structural review of the Palisades Nuclear Power Plant Unit 1 containment structure under combined loads for the Systematic Evaluation Program

    International Nuclear Information System (INIS)

    Liaw, C.Y.; Debeling, A.; Tsai, N.C.

    1981-12-01

    A structural reassessment of the containment structure of the Palisades Nuclear Power Plant Unit 1 was performed for the Nuclear Regulatory Commission as part of the Systematic Evaluation Program. Conclusions about the ability of the containment structure to withstand the Abnormal/Extreme Environment are presented. The reassessment focused mainly on the overall structural integrity of the containment building for the Abnormal/Extreme Environment. In this case, the Abnormal Environmental condition is caused by the worst case of either a Loss-of-Coolant Accident or a main steam line break. The Extreme Environmental condition is the Safe Shutdown Earthquake

  3. Evaluating the evidence: is phrenic nerve stimulation a safe and effective tool for decreasing ventilator dependence in patients with high cervical spinal cord injuries and central hypoventilation?

    Science.gov (United States)

    Sieg, Emily P; Payne, Russell A; Hazard, Sprague; Rizk, Elias

    2016-06-01

    Case reports, case series and case control studies have looked at the use of phrenic nerve stimulators in the setting of high spinal cord injuries and central hypoventilation syndromes dating back to the 1980s. We evaluated the evidence related to this topic by performing a systematic review of the published literature. Search terms "phrenic nerve stimulation," "phrenic nerve and spinal cord injury," and "phrenic nerve and central hypoventilation" were entered into standard search engines in a systematic fashion. Articles were reviewed by two study authors and graded independently for class of evidence according to published guidelines. The published evidence was reviewed, and the overall body of evidence was evaluated using the grading of recommendations, assesment, development and evaluations (GRADE) criteria Balshem et al. (J Clin Epidemiol 64:401-406, 2011). Our initial search yielded 420 articles. There were no class I, II, or III studies. There were 18 relevant class IV articles. There were no discrepancies among article ratings (i.e., kappa = 1). A meta-analysis could not be performed due to the low quality of the available evidence. The overall quality of the body of evidence was evaluated using GRADE criteria and fell within the "very poor" category. The quality of the published literature for phrenic nerve stimulation is poor. Our review of the literature suggests that phrenic nerve stimulation is a safe and effective option for decreasing ventilator dependence in high spinal cord injuries and central hypoventilation; however, we are left with critical questions that provide crucial directions for future studies.

  4. Evaluation of digital model accuracy and time-dependent deformation of alginate impressions.

    Science.gov (United States)

    Cesur, M G; Omurlu, I K; Ozer, T

    2017-09-01

    The aim of this study was to evaluate the accuracy of digital models produced with the three-dimensional dental scanner, and to test the dimensional stability of alginate impressions for durations of immediately (T0), 1 day (T1), and 2 days (T2). A total of sixty impressions were taken from a master model with an alginate, and were poured into plaster models in three different storage periods. Twenty impressions were directly scanned (negative digital models), after which plaster models were poured and scanned (positive digital models) immediately. The remaining 40 impressions were poured after 1 and 2 days. In total, 9 points and 11 linear measurements were used to analyze the plaster models, and negative and positive digital models. Time-dependent deformation of the alginate impressions and the accuracy of the conventional plaster models and digital models were evaluated separately. Plaster models, negative and positive digital models showed significant differences in nearly all measurements at T (0), T (1), and T (2) times (P 0.05), but they demonstrated statistically significant differences at T (2) time (P impressions is practicable method for orthodontists.

  5. Gender counts: A systematic review of evaluations of gender-integrated health interventions in low- and middle-income countries.

    Science.gov (United States)

    Schriver, Brittany; Mandal, Mahua; Muralidharan, Arundati; Nwosu, Anthony; Dayal, Radhika; Das, Madhumita; Fehringer, Jessica

    2017-11-01

    As a result of new global priorities, there is a growing need for high-quality evaluations of gender-integrated health programmes. This systematic review examined 99 peer-reviewed articles on evaluations of gender-integrated (accommodating and transformative) health programmes with regard to their theory of change (ToC), study design, gender integration in data collection, analysis, and gender measures used. Half of the evaluations explicitly described a ToC or conceptual framework (n = 50) that guided strategies for their interventions. Over half (61%) of the evaluations used quantitative methods exclusively; 11% used qualitative methods exclusively; and 28% used mixed methods. Qualitative methods were not commonly detailed. Evaluations of transformative interventions were less likely than those of accommodating interventions to employ randomised control trials. Two-thirds of the reviewed evaluations reported including at least one specific gender-related outcome (n = 18 accommodating, n = 44 transformative). To strengthen evaluations of gender-integrated programmes, we recommend use of ToCs, explicitly including gender in the ToC, use of gender-sensitive measures, mixed-method designs, in-depth descriptions of qualitative methods, and attention to gender-related factors in data collection logistics. We also recommend further research to develop valid and reliable gender measures that are globally relevant.

  6. Hypothermia after cardiac arrest should be further evaluated-A systematic review of randomised trials with meta-analysis and trial sequential analysis

    DEFF Research Database (Denmark)

    Nielsen, Niklas; Friberg, Hans; Gluud, Christian

    2011-01-01

    BACKGROUND: Guidelines recommend mild induced hypothermia (MIH) to reduce mortality and neurological impairment after out-of-hospital cardiac arrest. Our objective was to systematically evaluate the evidence for MIH taking into consideration the risks of systematic and random error and to GRADE...... the evidence. METHODS: Systematic review with meta-analysis and trial sequential analysis of randomised trials evaluating MIH after cardiac arrest in adults. We searched CENTRAL, MEDLINE, and EMBASE databases until May 2009. Retrieved trials were evaluated with Cochrane methodology. Meta-analytic estimates....... The substantial risk of bias and concerns with directness rated down the quality of the evidence to low. CONCLUSIONS: Evidence regarding MIH after out-of-hospital cardiac arrest is still inconclusive and associated with non-negligible risks of systematic and random errors. Using GRADE-methodology, we conclude...

  7. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans

    2014-01-01

    a substantially larger number of clinical scapular assessment methods than previously reported. Using the COSMIN checklist the methodological quality of the included measurement properties in the reliability and validity domains were in general ‘‘fair’’ to ‘‘poor’’. None were examined for all three domains: (1...... utility for clinical practice.......The aims were to compile a schematic overview of clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. A systematic, computerassisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October...

  8. Energy dependence evaluation of a ZnO detector for diagnostic X-ray beam

    International Nuclear Information System (INIS)

    Valença, C.P.V.; Silveira, M.A.L.; Macedo, M.A.; Santos, M.A.

    2015-01-01

    In the last decades the international organizations of human health and radiation protection have recommended certain care for using X-ray as a diagnosis tool. The current concern is to avoid any type of radiological accident or overdose to the patient. This can be done assessing the parameters of the X-ray equipment and there are various types of detectors available for that: ionizing chamber, semiconductor devices, etc. These detectors must be calibrated so that they can be used for any energy range and such a procedure is correlated with what is called the energy dependence of the detector. In accordance with the stated requirements of IEC 61267, the standard radiation quality beams and irradiation conditions (RQRs) are the tools and techniques for calibrating diagnostic X-Ray instruments and detectors. The purpose of this work is to evaluate the behavior of the energy dependence of a detector fabricated from a zinc oxide (ZnO) nanofilm. A Pantak industrial X-ray equipment was used to generate the RQR radiation quality beams and test three ZnO detector samples. A 6430 sub-femto-ammeter, Keithley, was used to bias the ZnO detector and simultaneously perform the output readings. The results showed that the ZnO device has some increase in its sensitivity to the ionizing radiation as the X-ray effective energy decreases unlike other types of semiconductor electronic devices typically used as an X-ray detector. We can be concluded that, after calibration, the ZnO device can be used as a diagnostic X-ray detector. (author)

  9. Evaluation of the energy dependence of a zinc oxide nanofilm X-ray detector

    International Nuclear Information System (INIS)

    Valenca, C.P.V.; Silveira, M.A.L.; Macedo, M.A.; Santos, L.A.P

    2015-01-01

    International organizations of human health and radiation protection have recommended certain care for using of the X-ray as a diagnosis tool to avoid any type of radiological accident or overdose to the patient. This can be done assessing the parameters of the X-ray equipment and there are various types of detectors available for that: ionizing chamber, electronic semiconductor devices, etc. These detectors must be calibrated so that they can be used for any energy range and such a procedure is correlated with what is called the energy dependence of the detector. In accordance with the stated requirements of IEC 61267, the standard radiation quality beams and irradiation conditions (RQRs) are the tools and techniques for calibrating diagnostic X-Ray instruments and detectors. The purpose of this work is to evaluate the behavior of the energy dependence of a detector fabricated from a zinc oxide (ZnO) nanofilm. A Pantak industrial X-ray equipment was used to generate the RQR radiation quality beams and test three ZnO detector samples. A 6430 sub-femto-ammeter, Keithley, was used to bias the ZnO detector and simultaneously perform the output readings. The results showed that the ZnO device has some increase in its sensitivity to the ionizing radiation as the X-ray effective energy decreases unlike other types of semiconductor electronic devices typically used as an X-ray detector. We can conclude that the ZnO device can be used as a diagnostic X-ray detector with an appropriate calibration. (author)

  10. Systematic Evaluation Strategies for Innovative Programs in Health Professions Education: Need, Function and Components.

    Science.gov (United States)

    Taft, Thomas B., Jr.; Logan, Nelson S.

    As change occurs in various health sciences programs, evaluational strategies should be developed so that adaptive decisions may be made. Evaluation models taking into account inputs, methodology, and outputs (Stake, 1967, and Astin and Panes, 1971) need examination. Alternative measurement instruments for formative and summative evaluations,…

  11. The methodological quality of economic evaluation studies in obstetrics and gynecology: a systematic review

    NARCIS (Netherlands)

    Vijgen, Sylvia M. C.; Opmeer, Brent C.; Mol, Ben Willem J.

    2013-01-01

    We evaluated the methodological quality of economic evaluation studies in the field of obstetrics and gynecology published in the last decade. A MEDLINE search was performed to find economic evaluation studies in obstetrics and gynecology from the years 1997 through 2009. We included full economic

  12. Evaluation of Open and Minimally Invasive Adrenalectomy: A Systematic Review and Network Meta-analysis.

    Science.gov (United States)

    Heger, Patrick; Probst, Pascal; Hüttner, Felix J; Gooßen, Käthe; Proctor, Tanja; Müller-Stich, Beat P; Strobel, Oliver; Büchler, Markus W; Diener, Markus K

    2017-11-01

    Adrenalectomy can be performed via open and various minimally invasive approaches. The aim of this systematic review was to summarize the current evidence on surgical techniques of adrenalectomy. Systematic literature searches (MEDLINE, EMBASE, Web of Science, Cochrane Library) were conducted to identify randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing at least two surgical procedures for adrenalectomy. Statistical analyses were performed, and meta-analyses were conducted. Furthermore, an indirect comparison of RCTs and a network meta-analysis of CCTs were carried out for each outcome. Twenty-six trials (1710 patients) were included. Postoperative complication rates did not show differences for open and minimally invasive techniques. Operation time was significantly shorter for open adrenalectomy than for the robotic approach (p meta-analysis showed open adrenalectomy to be the fastest technique. Blood loss was significantly reduced in the robotic arm compared with open and laparoscopic adrenalectomy (p = 0.01). Length of hospital stay (LOS) was significantly lower after conventional laparoscopy than open adrenalectomy in CCTs (p meta-analysis revealed the lowest LOS after retroperitoneoscopic adrenalectomy. Minimally invasive adrenalectomy is safe and should be preferred over open adrenalectomy due to shorter LOS, lower blood loss, and equivalent complication rates. The retroperitoneoscopic access features the shortest LOS and operating time. Further high-quality RCTs are warranted, especially to compare the posterior retroperitoneoscopic and the transperitoneal robotic approach.

  13. Exploring Secondary Students' Epistemological Features Depending on the Evaluation Levels of the Group Model on Blood Circulation

    Science.gov (United States)

    Lee, Shinyoung; Kim, Heui-Baik

    2014-01-01

    The purpose of this study is to identify the epistemological features and model qualities depending on model evaluation levels and to explore the reasoning process behind high-level evaluation through small group interaction about blood circulation. Nine groups of three to four students in the eighth grade participated in the modeling practice.…

  14. A systematic method for using 3D echocardiography to evaluate tricuspid valve insufficiency in hypoplastic left heart syndrome.

    Science.gov (United States)

    Mart, Christopher Robin; Eckhauser, Aaron Wesley; Murri, Michael; Su, Jason Thomas

    2014-09-01

    With surgical palliation of hypoplastic left heart syndrome (HLHS), the tricuspid valve (TV) becomes the systemic atrioventricular valve and moderate/severe TV insufficiency (TVI), an adverse risk factor for survival to Fontan, has been reported in up to 35% of patients prior to stage I palliation. Precise echocardiographic identification of the mechanism of TVI cannot be determined by two-dimensional echocardiography. Three-dimensional echocardiography (3DE) can provide significant insight into the mechanisms of TVI. It is the intent of this report to propose a systematic method on how to evaluate and display 3DE images of the TV in HLHS which has not been done previously. TV anatomy, function, and the known mechanisms of insufficiency are reviewed. We defined three regions of the TV (anterior, posterior, septal) that can help define valve "leaflets" that incorporates the many variations of TV anatomy. To determine how the surgeon views the TV, a picture of a pathologic specimen of the TV was placed on a computer screen and rotated until it was oriented as it appears during surgery, the "surgeons view." We have proposed a systematic method for evaluating and displaying the TV using 3DE which can provide significant insight into the mechanisms causing TVI in HLHS. This has the potential to improve both the surgical approach to repairing the valve and, ultimately, patient outcomes.

  15. Economic evaluations of follow-up strategies for cancer survivors: a systematic review and quality appraisal of the literature.

    Science.gov (United States)

    Meregaglia, Michela; Cairns, John

    2015-01-01

    The aim of this study was to review and critically assess the health economics literature on post-treatment follow-up for adult cancer survivors. A systematic search was performed using PubMed, EMBASE and the Cochrane Library. The Consolidated Health Economic Evaluation Reporting Standards checklist was adopted to assess the quality of the included studies. Thirty-nine articles met the eligibility criteria. Around two thirds of the studies addressed the most common cancers (i.e., breast, colorectal, cervical and lung); 21 were based on a single clinical study, while the rest were modeling papers. All types of economic evaluations were represented other than cost-benefit analysis. The overall quality was generally high with an average proportion of 74% of checklist criteria fulfilled. The cost-effectiveness results supported the current trend towards less intensive, primary care-based and risk-adapted follow-up schemes.

  16. Integrated plant safety assessment: systematic evaluation program. Haddam Neck Plant, Connecticut Yankee Atomic Power Company. Docket No. 50-213

    International Nuclear Information System (INIS)

    1983-03-01

    The Systematic Evaluation Program was initiated in February 1977 by the US Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to confirm and document their safety. The review provides: (1) an assessment of how these plants compare with current licensing safety requirements relating to selected issues, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. This report documents the review of Haddam Neck Plant, operated by Connecticut Yankee Atomic Power Company. The Haddam Neck Plant is one of 10 plants reviewed under Phase II of this program. This report indicates how 137 topics selected for review under Phase I of the program were addressed. Equipment and procedural changes have been identified as a result of the review

  17. Evaluation of medicinal interventions for the management of oral submucous fibrosis: a systematic review of the literature.

    Science.gov (United States)

    Awan, Kamran Habib; Patil, Shankargouda; Habib, Syed Rashid; Pejcic, Ana; Zain, Rosnah Binti

    2014-11-01

    Oral submucous fibrosis is a chronic, progressive scarring disease associated with both significant morbidity including pain and limited mouth opening and an increased risk for malignancy. This systematic review evaluated the different medicinal (i.e. nonsurgical) interventions available for the management of oral submucous fibrosis. An automated literature searches of online databases from January 1960 to December 2013 were performed and only studies with high level of evidence based on the guidelines of the Oxford Centre for evidence-based medicine were selected. Thirteen studies (3 randomized controlled trials and 10 clinical trials/controlled clinical trials) were included and drugs like steroids, hyaluronidase, human placenta extracts, chymotrypsin and collagenase, pentoxifylline, nylidrin hydrochloride, iron and multivitamin supplements including lycopene were used. There is a clear lack of evidence on the available drug treatment for oral submucous fibrosis and further high quality randomized controlled trials are needed to evaluate the different therapeutic agents.

  18. Methods of Blood Oxygen Level-Dependent Magnetic Resonance Imaging Analysis for Evaluating Renal Oxygenation

    Directory of Open Access Journals (Sweden)

    Fen Chen

    2018-03-01

    Full Text Available Blood oxygen level-dependent magnetic resonance imaging (BOLD MRI has recently been utilized as a noninvasive tool for evaluating renal oxygenation. Several methods have been proposed for analyzing BOLD images. Regional ROI selection is the earliest and most widely used method for BOLD analysis. In the last 20 years, many investigators have used this method to evaluate cortical and medullary oxygenation in patients with ischemic nephropathy, hypertensive nephropathy, diabetic nephropathy, chronic kidney disease (CKD, acute kidney injury and renal allograft rejection. However, clinical trials of BOLD MRI using regional ROI selection revealed that it was difficult to distinguish the renal cortico-medullary zones with this method, and that it was susceptible to observer variability. To overcome these deficiencies, several new methods were proposed for analyzing BOLD images, including the compartmental approach, fractional hypoxia method, concentric objects (CO method and twelve-layer concentric objects (TLCO method. The compartmental approach provides an algorithm to judge whether the pixel belongs to the cortex or medulla. Fractional kidney hypoxia, measured by using BOLD MRI, was negatively correlated with renal blood flow, tissue perfusion and glomerular filtration rate (GFR in patients with atherosclerotic renal artery stenosis. The CO method divides the renal parenchyma into six or twelve layers of thickness in each coronal slice of BOLD images and provides a R2* radial profile curve. The slope of the R2* curve associated positively with eGFR in CKD patients. Indeed, each method invariably has advantages and disadvantages, and there is generally no consensus method so far. Undoubtedly, analytic approaches for BOLD MRI with better reproducibility would assist clinicians in monitoring the degree of kidney hypoxia and thus facilitating timely reversal of tissue hypoxia.

  19. Diffusion Capillary Phantom vs. Human Data: Outcomes for Reconstruction Methods Depend on Evaluation Medium

    Directory of Open Access Journals (Sweden)

    Sarah D. Lichenstein

    2016-09-01

    Full Text Available Purpose: Diffusion MRI provides a non-invasive way of estimating structural connectivity in the brain. Many studies have used diffusion phantoms as benchmarks to assess the performance of different tractography reconstruction algorithms and assumed that the results can be applied to in vivo studies. Here we examined whether quality metrics derived from a common, publically available, diffusion phantom can reliably predict tractography performance in human white matter tissue. Material and Methods: We compared estimates of fiber length and fiber crossing among a simple tensor model (diffusion tensor imaging, a more complicated model (ball-and-sticks and model-free (diffusion spectrum imaging, generalized q-sampling imaging reconstruction methods using a capillary phantom and in vivo human data (N=14. Results: Our analysis showed that evaluation outcomes differ depending on whether they were obtained from phantom or human data. Specifically, the diffusion phantom favored a more complicated model over a simple tensor model or model-free methods for resolving crossing fibers. On the other hand, the human studies showed the opposite pattern of results, with the model-free methods being more advantageous than model-based methods or simple tensor models. This performance difference was consistent across several metrics, including estimating fiber length and resolving fiber crossings in established white matter pathways. Conclusions: These findings indicate that the construction of current capillary diffusion phantoms tends to favor complicated reconstruction models over a simple tensor model or model-free methods, whereas the in vivo data tends to produce opposite results. This brings into question the previous phantom-based evaluation approaches and suggests that a more realistic phantom or simulation is necessary to accurately predict the relative performance of different tractography reconstruction methods. Acronyms: BSM: ball-and-sticks model; d

  20. Evaluation of helper-dependent canine adenovirus vectors in a 3D human CNS model

    Science.gov (United States)

    Simão, Daniel; Pinto, Catarina; Fernandes, Paulo; Peddie, Christopher J.; Piersanti, Stefania; Collinson, Lucy M.; Salinas, Sara; Saggio, Isabella; Schiavo, Giampietro; Kremer, Eric J.; Brito, Catarina; Alves, Paula M.

    2017-01-01

    Gene therapy is a promising approach with enormous potential for treatment of neurodegenerative disorders. Viral vectors derived from canine adenovirus type 2 (CAV-2) present attractive features for gene delivery strategies in the human brain, by preferentially transducing neurons, are capable of efficient axonal transport to afferent brain structures, have a 30-kb cloning capacity and have low innate and induced immunogenicity in pre-clinical tests. For clinical translation, in-depth pre-clinical evaluation of efficacy and safety in a human setting is primordial. Stem cell-derived human neural cells have a great potential as complementary tools by bridging the gap between animal models, which often diverge considerably from human phenotype, and clinical trials. Herein, we explore helper-dependent CAV-2 (hd-CAV-2) efficacy and safety for gene delivery in a human stem cell-derived 3D neural in vitro model. Assessment of hd-CAV-2 vector efficacy was performed at different multiplicities of infection, by evaluating transgene expression and impact on cell viability, ultrastructural cellular organization and neuronal gene expression. Under optimized conditions, hd-CAV-2 transduction led to stable long-term transgene expression with minimal toxicity. hd-CAV-2 preferentially transduced neurons, while human adenovirus type 5 (HAdV5) showed increased tropism towards glial cells. This work demonstrates, in a physiologically relevant 3D model, that hd-CAV-2 vectors are efficient tools for gene delivery to human neurons, with stable long-term transgene expression and minimal cytotoxicity. PMID:26181626

  1. Patient-reported outcome instruments that evaluate adherence behaviours in adults with asthma: A systematic review of measurement properties.

    Science.gov (United States)

    Gagné, Myriam; Boulet, Louis-Philippe; Pérez, Norma; Moisan, Jocelyne

    2018-04-30

    To systematically identify the measurement properties of patient-reported outcome instruments (PROs) that evaluate adherence to inhaled maintenance medication in adults with asthma. We conducted a systematic review of six databases. Two reviewers independently included studies on the measurement properties of PROs that evaluated adherence in asthmatic participants aged ≥18 years. Based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN), the reviewers (1) extracted data on internal consistency, reliability, measurement error, content validity, structural validity, hypotheses testing, cross-cultural validity, criterion validity, and responsiveness; (2) assessed the methodological quality of the included studies; (3) assessed the quality of the measurement properties (positive or negative); and (4) summarised the level of evidence (limited, moderate, or strong). We screened 6,068 records and included 15 studies (14 PROs). No studies evaluated measurement error or responsiveness. Based on methodological and measurement property quality assessments, we found limited positive evidence of: (a) internal consistency of the Adherence Questionnaire, Refined Medication Adherence Reason Scale (MAR-Scale), Medication Adherence Report Scale for Asthma (MARS-A), and Test of the Adherence to Inhalers (TAI); (b) reliability of the TAI; and (c) structural validity of the Adherence Questionnaire, MAR-Scale, MARS-A, and TAI. We also found limited negative evidence of: (d) hypotheses testing of Adherence Questionnaire; (e) reliability of the MARS-A; and (f) criterion validity of the MARS-A and TAI. Our results highlighted the need to conduct further high-quality studies that will positively evaluate the reliability, validity, and responsiveness of the available PROs. This article is protected by copyright. All rights reserved.

  2. Economic Evaluations of Multicomponent Disease Management Programs with Markov Models: A Systematic Review.

    Science.gov (United States)

    Kirsch, Florian

    2016-12-01

    Disease management programs (DMPs) for chronic diseases are being increasingly implemented worldwide. To present a systematic overview of the economic effects of DMPs with Markov models. The quality of the models is assessed, the method by which the DMP intervention is incorporated into the model is examined, and the differences in the structure and data used in the models are considered. A literature search was conducted; the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed to ensure systematic selection of the articles. Study characteristics e.g. results, the intensity of the DMP and usual care, model design, time horizon, discount rates, utility measures, and cost-of-illness were extracted from the reviewed studies. Model quality was assessed by two researchers with two different appraisals: one proposed by Philips et al. (Good practice guidelines for decision-analytic modelling in health technology assessment: a review and consolidation of quality asessment. Pharmacoeconomics 2006;24:355-71) and the other proposed by Caro et al. (Questionnaire to assess relevance and credibility of modeling studies for informing health care decision making: an ISPOR-AMCP-NPC Good Practice Task Force report. Value Health 2014;17:174-82). A total of 16 studies (9 on chronic heart disease, 2 on asthma, and 5 on diabetes) met the inclusion criteria. Five studies reported cost savings and 11 studies reported additional costs. In the quality, the overall score of the models ranged from 39% to 65%, it ranged from 34% to 52%. Eleven models integrated effectiveness derived from a clinical trial or a meta-analysis of complete DMPs and only five models combined intervention effects from different sources into a DMP. The main limitations of the models are bad reporting practice and the variation in the selection of input parameters. Eleven of the 14 studies reported cost-effectiveness results of less than $30,000 per quality-adjusted life-year and

  3. The Evaluation of Bioelectrical Activity of Pelvic Floor Muscles Depending on Probe Location: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Tomasz Halski

    2013-01-01

    Full Text Available Objectives. The main objective was to determine how the depth of probe placement affects functional and resting bioelectrical activity of the PFM and whether the recorded signal might be dependent on the direction in which the probe is rotated. Participants. The study comprised of healthy, nulliparous women between the ages of 21 and 25. Outcome Measures. Bioelectric activity of the PFM was recorded from four locations of the vagina by surface EMG and vaginal probe. Results. There were no statistically significant differences between the results during functional sEMG activity. During resting sEMG activity, the highest bioelectrical activity of the PFM was observed in the L1 and the lowest in the L4 and a statistically significant difference between the highest and the lowest results of resting sEMG activity was observed (P=0.0043. Conclusion. Different electrodes placement during functional contraction of PFM does not affect the obtained results in sEMG evaluation. In order to diagnose the highest resting activity of PFM the recording plates should be placed toward the anterior vaginal wall and distally from the introitus. However, all of the PFM have similar bioelectrical activity and it seems that these muscles could be treated as a single muscle.

  4. Health economic evaluation in lumbar spinal fusion: a systematic literature review anno 2005

    DEFF Research Database (Denmark)

    Soegaard, Rikke; Christensen, Finn B

    2006-01-01

    in clinical practice are present, economic evaluation is needed in order to facilitate the decision-makers' budget allocations. NHS Economic Evaluation Database, MEDLINE, EMBASE and Cochrane Library were searched. Two independent reviewers (one clinical content expert and one economic content expert) applied...... that the clinical effects are statistically synonymous, it does not support the use of high-cost techniques. There is a great potential for improvement of methodological quality in economic evaluations of lumbar spinal fusion and further research is imperative....

  5. Evaluation of systematic I-131 thyroid measurements for nuclear medicine workers

    International Nuclear Information System (INIS)

    Puscalau, M.A.

    2002-01-01

    In Nuclear Medicine, I-131 is used intensively for the diagnosis and for the treatment of the different severities maladies of the thyroid. This radionuclide generates an important internal contamination to the patients, because of its oral administration, and, also, through inhalation, to the workers involved in the radiopharmaceuticals production , to the nursing staff and to the physicians that care and treat the patients in the hospitals. The paper presents the data obtained by systematically thyroid monitoring of the physicians and nurses from the Endocrinology Hospital, that are contaminated by I-131 inhalation because of their permanent relation with the patients treated with 3.7 MBq I-131 for investigation and with activities in the range 1100 MBq - 4000 MBq for therapy. The measurements were carried out with our Body Counter equipped with a NaI(Tl) scintillation detector, 50 mm thickness and 40mm diameter. Values of the estimated committed equivalent doses are, also, reported

  6. Systematic evaluation of common lubricants for optimal use in tablet formulation.

    Science.gov (United States)

    Paul, Shubhajit; Sun, Changquan Calvin

    2018-05-30

    As an essential formulation component for large-scale tablet manufacturing, the lubricant preserves tooling by reducing die-wall friction. Unfortunately, lubrication also often results in adverse effects on tablet characteristics, such as prolonged disintegration, slowed dissolution, and reduced mechanical strength. Therefore, the choice of lubricant and its optimal concentration in a tablet formulation is a critical decision in tablet formulation development to attain low die-wall friction while minimizing negative impact on other tablet properties. Three commercially available tablet lubricants, i.e., magnesium stearate, sodium stearyl fumerate, and stearic acid, were systematically investigated in both plastic and brittle matrices to elucidate their effects on reducing die-wall friction, tablet strength, tablet hardness, tablet friability, and tablet disintegration kinetics. Clear understanding of the lubrication efficiency of commonly used lubricants as well as their impact on tablet characteristics would help future tablet formulation efforts. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Systematic preparation, execution and evaluation of emergency exercises at the Beznau nuclear power plant

    International Nuclear Information System (INIS)

    Tenschert, J.

    2011-01-01

    Based on federal acts and a specific guideline of the nuclear authority ENSI, strict requirements are imposed on emergency exercises at Swiss NPPs. The Beznau NPP has conducted emergency exercises for more than 30 years. Systematic exercise planning assures that all emergency cases defined in the plant-specific emergency plan are considered in the exercise scenarios. Technically oriented scenarios cover all groups of initiating events and all safety levels of the defense in depth principle. The exercise results are an important input for optimization measures in the areas of emergency organization, documentation and infrastructure. Due to the goal-oriented enforcement of laws and guidelines by the nuclear authority ENSI, emergency exercises serve as a motor of further optimization of emergency preparedness. (orig.)

  8. Evaluation of the scientific impact of the Ebola epidemic: a systematic review.

    Science.gov (United States)

    Mutters, N T; Malek, V; Agnandji, S T; Günther, F; Tacconelli, E

    2017-09-04

    The Ebola outbreak prompted an extensive number of scientific publications, but little attention has been paid to the involvement of local scientists, distribution of research funding and related publications. We sought to systematically review publicly available information on the scientific impact of the Ebola epidemic. A systematic review of literature on the Ebola outbreak was performed. Extracted information included origins of the authors, type and distribution of funding, and impact factors (IF) of related publications between 6 December 2013, and 22 December 2015. We identified 460 relevant articles out of 3281 references, which were mostly authored by American (46.6%) and European (28.4%) institutions; only 13.4% of authors were affiliated with African institutions. Most IF can be attributed to the Americas and Europe, with 43% (25 030.8 IF) and 34.5% (20 074.2 IF), respectively, compared with 17.9% (10 436.5 IF) in Africa. Funds were provided mainly by the Americas (31.8% of all funded studies) and Europe (17%). American and European funds were also distributed back, mainly to American (77.8%) and European (85.2%) institutions, respectively. The Ebola outbreak had a significant scientific impact and resulted in numerous publications in high IF journals. The main impact could be measured in the Americas and Europe, and was directly related to funding. African researchers were only marginally involved in the scientific processing (86.6% of all researchers were not African), probably because major research centres are located in America and Europe. Our results suggest the importance of promoting closer cooperation between regions. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  9. Clinical effectiveness, tolerability and cost-effectiveness of newer drugs for epilepsy in adults: a systematic review and economic evaluation.

    Science.gov (United States)

    Wilby, J; Kainth, A; Hawkins, N; Epstein, D; McIntosh, H; McDaid, C; Mason, A; Golder, S; O'Meara, S; Sculpher, M; Drummond, M; Forbes, C

    2005-04-01

    To examine the clinical effectiveness, tolerability and cost-effectiveness of gabapentin (GBP), lamotrigine (LTG), levetiracetam (LEV), oxcarbazepine (OXC), tiagabine (TGB), topiramate (TPM) and vigabatrin (VGB) for epilepsy in adults. Electronic databases. Internet resources. Pharmaceutical company submissions. Selected studies were screened and quality assessed. Separate analyses assessed clinical effectiveness, serious, rare and long-term adverse events and cost-effectiveness. An integrated economic analysis incorporating information on costs and effects of newer and older antiepileptic drugs (AEDs) was performed to give direct comparisons of long-term costs and benefits. A total of 212 studies were included in the review. All included systematic reviews were Cochrane reviews and of good quality. The quality of randomised controlled trials (RCTs) was variable. Assessment was hampered by poor reporting of methods of randomisation, allocation concealment and blinding. Few of the non-randomised studies were of good quality. The main weakness of the economic evaluations was inappropriate use of the cost-minimisation design. The included systematic reviews reported that newer AEDs were effective as adjunctive therapy compared to placebo. For newer versus older drugs, data were available for all three monotherapy AEDs, although data for OXC and TPM were limited. There was limited, poor-quality evidence of a significant improvement in cognitive function with LTG and OXC compared with older AEDs. However, there were no consistent statistically significant differences in other clinical outcomes, including proportion of seizure-free patients. No studies assessed effectiveness of AEDs in people with intellectual disabilities or in pregnant women. There was very little evidence to assess the effectiveness of AEDs in the elderly; no significant differences were found between LTG and carbamazepine monotherapy. Sixty-seven RCTs compared adjunctive therapy with placebo, older

  10. Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: A practical review for clinical researchers-Part I. general guidance and tips

    International Nuclear Information System (INIS)

    Kim, Kyung Won; Choi, Sang Hyun; Huh, Jimi; Park, Seong Ho; Lee, June Young

    2015-01-01

    In the field of diagnostic test accuracy (DTA), the use of systematic review and meta-analyses is steadily increasing. By means of objective evaluation of all available primary studies, these two processes generate an evidence-based systematic summary regarding a specific research topic. The methodology for systematic review and meta-analysis in DTA studies differs from that in therapeutic/interventional studies, and its content is still evolving. Here we review the overall process from a practical standpoint, which may serve as a reference for those who implement these methods

  11. A systematic framework for the feasibility and technical evaluation of reactive distillation processes

    NARCIS (Netherlands)

    Shah, M.R.; Kiss, A.A.; Zondervan, E.; Haan, de A.B.

    2012-01-01

    This study presents a novel design methodology for the feasibility and technical evaluation of reactive distillation (RD), and discusses the applicability of various design methods of RD. The proposed framework for the feasibility evaluation determines the boundary conditions (e.g. relative

  12. Evaluation Criteria of Noninvasive Telemonitoring for Patients With Heart Failure: Systematic Review.

    Science.gov (United States)

    Farnia, Troskah; Jaulent, Marie-Christine; Steichen, Olivier

    2018-01-16

    Telemonitoring can improve heart failure (HF) management, but there is no standardized evaluation framework to comprehensively evaluate its impact. Our objectives were to list the criteria used in published evaluations of noninvasive HF telemonitoring projects, describe how they are used in the evaluation studies, and organize them into a consistent scheme. Articles published from January 1990 to August 2015 were obtained through MEDLINE, Web of Science, and EMBASE. Articles were eligible if they were original reports of a noninvasive HF telemonitoring evaluation study in the English language. Studies of implantable telemonitoring devices were excluded. Each selected article was screened to extract the description of the telemonitoring project and the evaluation process and criteria. A qualitative synthesis was performed. We identified and reviewed 128 articles leading to 52 evaluation criteria classified into 6 dimensions: clinical, economic, user perspective, educational, organizational, and technical. The clinical and economic impacts were evaluated in more than 70% of studies, whereas the educational, organizational, and technical impacts were studied in fewer than 15%. User perspective was the most frequently covered dimension in the development phase of telemonitoring projects, whereas clinical and economic impacts were the focus of later phases. Telemonitoring evaluation frameworks should cover all 6 dimensions appropriately distributed along the telemonitoring project lifecycle. Our next goal is to build such a comprehensive evaluation framework for telemonitoring and test it on an ongoing noninvasive HF telemonitoring project. ©Troskah Farnia, Marie-Christine Jaulent, Olivier Steichen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.01.2018.

  13. Economic evaluation of manual therapy for musculoskeletal diseases: a protocol for a systematic review and narrative synthesis of evidence.

    Science.gov (United States)

    Kim, Chang-Gon; Mun, Su-Jeong; Kim, Ka-Na; Shin, Byung-Cheul; Kim, Nam-Kwen; Lee, Dong-Hyo; Lee, Jung-Han

    2016-05-13

    Manual therapy is the non-surgical conservative management of musculoskeletal disorders using the practitioner's hands on the patient's body for diagnosing and treating disease. The aim of this study is to systematically review trial-based economic evaluations of manual therapy relative to other interventions used for the management of musculoskeletal diseases. Randomised clinical trials (RCTs) on the economic evaluation of manual therapy for musculoskeletal diseases will be included in the review. The following databases will be searched from their inception: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Econlit, Mantis, Index to Chiropractic Literature, Science Citation Index, Social Science Citation Index, Allied and Complementary Medicine Database (AMED), Cochrane Database of Systematic Reviews (CDSR), National Health Service Database of Abstracts of Reviews of Effects (NHS DARE), National Health Service Health Technology Assessment Database (NHS HTA), National Health Service Economic Evaluation Database (NHS EED), CENTRAL, five Korean medical databases (Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Service System (RISS), DBPIA, Korean Traditional Knowledge Portal (KTKP) and KoreaMed) and three Chinese databases (China National Knowledge Infrastructure (CNKI), VIP and Wanfang). The evidence for the cost-effectiveness, cost-utility and cost-benefit of manual therapy for musculoskeletal diseases will be assessed as the primary outcome. Health-related quality of life and adverse effects will be assessed as secondary outcomes. We will critically appraise the included studies using the Cochrane risk of bias tool and the Drummond checklist. Results will be summarised using Slavin's qualitative best-evidence synthesis approach. The results of the study will be disseminated via a peer-reviewed journal and/or conference presentations

  14. A study on a systematic method for evaluating values of raised concerns

    International Nuclear Information System (INIS)

    Sawada, T.; Morimoto, T.; Iida, N.; Nishimura, T.; Soda, Y.; Itoh, K.; Tanaka, H.

    2006-01-01

    The objective of this study is to develop a methodology that can externalise potential concerns and evaluate the values of the concerns raised in corporations. By implementing this methodology into corporate governance, it is expected to improve the work environment and enhance the capability for the corporate governance through supporting the internal autonomic purification. This study comprises of: case studies of past wrongdoings in corporations such as JCO and Tokyo Electric Power Company (TEPCO); identifying the viewpoints for evaluating values of raised concerns; developing a model to evaluate the values. (author)

  15. Critical evaluation of paliperidone in the treatment of schizophrenia in Chinese patients: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Zhang LL

    2016-01-01

    Full Text Available LiLi Zhang,1 JiTao Li,2–4 YanJie Zhao,5 Yun’Ai Su,2–4 Tianmei Si2–4 1Medical Affairs, Xian Janssen Pharmaceutical Co, Ltd, 2National Clinical Research Center for Mental Disorders, 3Peking University Sixth Hospital, Institute of Mental Health, 4The Key Laboratory of Mental Health, Ministry of Health, Peking University, 5National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China Background: Paliperidone (9-hydroxyrisperidone, the major active metabolite of risperidone, has been introduced as a novel atypical antipsychotic agent in many countries. It is available both as an oral extended-release (ER formulation and as a long-acting injection (paliperidone palmitate, PP, which have been approved for treating schizophrenia in the People’s Republic of China since 2009 and 2012, respectively. This systematic review summarizes the efficacy, effectiveness, and safety of paliperidone in the treatment of schizophrenia in the Chinese population. Methods: A systematic literature search was conducted on the databases covering international and Chinese core journals, published from January 1, 2008, to May 22, 2015. Results: A total of 122 publications were retrieved, of which 63 studies were identified for inclusion; most studies were related to paliperidone ER (n=53, nine were related to PP, and one study was related to both agents. Paliperidone ER demonstrated at least comparable efficacy with active comparators, including risperidone, olanzapine, ziprasidone, or aripiprazole, and was found to be superior with respect to the onset of action and improvement in the Personal and Social Performance Scale score. Paliperidone ER appeared to be associated with a lower risk of metabolic syndromes; the most common treatment-emergent adverse events were extrapyramidal symptoms, akathisia, insomnia, and somnolence. Results from interventional and observational studies showed that PP

  16. NatHER: protocol for systematic evaluation of trends in survival among patients with HER2-positive advanced breast cancer.

    Science.gov (United States)

    Korner, Eli J; Morris, Anne; Allen, Isabel Elaine; Hurvitz, Sara; Beattie, Mary S; Kalesan, Bindu

    2015-10-01

    Human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) is an aggressive form of breast cancer and is historically associated with poor outcomes compared with HER2-negative MBC. Since 1998, four drugs have been globally approved for the targeted treatment of HER2-positive MBC. Additional advances in patient care-such as improved breast cancer screening, HER2 testing, and supportive care-have also occurred. The objective of this systematic review and meta-analysis is to determine whether there has been a cumulative change in survival over time in patients with HER2-positive advanced breast cancer based on results from interventional clinical trials (ICTs) and observational studies and to compare outcomes across these types of studies. A systematic search of Medline, EMBASE, and the Cochrane Central Register of Controlled Trials will be performed. Two investigators will independently assess each abstract for inclusion. English language reports of ICTs and observational studies that include patients with HER2-positive advanced breast cancer from 1987 onwards will be considered. The primary outcome of interest is overall survival; secondary outcomes include progression-free survival and safety. Data on clinical outcomes, as well as on study design, study population, treatment/intervention, methodological quality, and outcomes, will be extracted using a structured codebook developed by the authors for this study. Standard and cumulative random effects meta-analysis will be performed to derive pooled risk estimates, both overall and by study design, controlling for covariates such as aggregate demographic and clinical characteristics of patients, treatment/intervention, and study characteristics. Heterogeneity of studies will be evaluated using the I(2) statistic. Differences in risk estimates by quality characteristics will be performed using meta-regression. This study will evaluate current and evolving trends in survival associated with

  17. Model-based economic evaluations in smoking cessation and their transferability to new contexts: a systematic review.

    Science.gov (United States)

    Berg, Marrit L; Cheung, Kei Long; Hiligsmann, Mickaël; Evers, Silvia; de Kinderen, Reina J A; Kulchaitanaroaj, Puttarin; Pokhrel, Subhash

    2017-06-01

    To identify different types of models used in economic evaluations of smoking cessation, analyse the quality of the included models examining their attributes and ascertain their transferability to a new context. A systematic review of the literature on the economic evaluation of smoking cessation interventions published between 1996 and April 2015, identified via Medline, EMBASE, National Health Service (NHS) Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA). The checklist-based quality of the included studies and transferability scores was based on the European Network of Health Economic Evaluation Databases (EURONHEED) criteria. Studies that were not in smoking cessation, not original research, not a model-based economic evaluation, that did not consider adult population and not from a high-income country were excluded. Among the 64 economic evaluations included in the review, the state-transition Markov model was the most frequently used method (n = 30/64), with quality adjusted life years (QALY) being the most frequently used outcome measure in a life-time horizon. A small number of the included studies (13 of 64) were eligible for EURONHEED transferability checklist. The overall transferability scores ranged from 0.50 to 0.97, with an average score of 0.75. The average score per section was 0.69 (range = 0.35-0.92). The relative transferability of the studies could not be established due to a limitation present in the EURONHEED method. All existing economic evaluations in smoking cessation lack in one or more key study attributes necessary to be fully transferable to a new context. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

  18. Model‐based economic evaluations in smoking cessation and their transferability to new contexts: a systematic review

    Science.gov (United States)

    Berg, Marrit L.; Cheung, Kei Long; Hiligsmann, Mickaël; Evers, Silvia; de Kinderen, Reina J. A.; Kulchaitanaroaj, Puttarin

    2017-01-01

    Abstract Aims To identify different types of models used in economic evaluations of smoking cessation, analyse the quality of the included models examining their attributes and ascertain their transferability to a new context. Methods A systematic review of the literature on the economic evaluation of smoking cessation interventions published between 1996 and April 2015, identified via Medline, EMBASE, National Health Service (NHS) Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA). The checklist‐based quality of the included studies and transferability scores was based on the European Network of Health Economic Evaluation Databases (EURONHEED) criteria. Studies that were not in smoking cessation, not original research, not a model‐based economic evaluation, that did not consider adult population and not from a high‐income country were excluded. Findings Among the 64 economic evaluations included in the review, the state‐transition Markov model was the most frequently used method (n = 30/64), with quality adjusted life years (QALY) being the most frequently used outcome measure in a life‐time horizon. A small number of the included studies (13 of 64) were eligible for EURONHEED transferability checklist. The overall transferability scores ranged from 0.50 to 0.97, with an average score of 0.75. The average score per section was 0.69 (range = 0.35–0.92). The relative transferability of the studies could not be established due to a limitation present in the EURONHEED method. Conclusion All existing economic evaluations in smoking cessation lack in one or more key study attributes necessary to be fully transferable to a new context. PMID:28060453

  19. Reach, engagement, and effectiveness: a systematic review of evaluation methodologies used in health promotion via social networking sites.

    Science.gov (United States)

    Lim, Megan S C; Wright, Cassandra J C; Carrotte, Elise R; Pedrana, Alisa E

    2016-02-01

    Issue addressed Social networking sites (SNS) are increasingly popular platforms for health promotion. Advancements in SNS health promotion require quality evidence; however, interventions are often not formally evaluated. This study aims to describe evaluation practices used in SNS health promotion. Methods A systematic review was undertaken of Medline, PsycINFO, Scopus, EMBASE, CINAHL Plus, Communication and Mass Media Complete, and Cochrane Library databases. Articles published between 2006 and 2013 describing any health promotion intervention delivered using SNS were included. Results Forty-seven studies were included. There were two main evaluation approaches: closed designs (n=23), which used traditional research designs and formal recruitment procedures; and open designs (n=19), which evaluated the intervention in a real-world setting, allowing unknown SNS users to interact with the content without enrolling in research. Closed designs were unable to assess reach and engagement beyond their research sample. Open designs often relied on weaker study designs with no use of objective outcome measures and yielded low response rates. Conclusions Barriers to evaluation included low participation rates, high attrition, unknown representativeness and lack of comparison groups. Acceptability was typically assessed among those engaged with the intervention, with limited population data available to accurately assess intervention reach. Few studies were able to assess uptake of the intervention in a real-life setting while simultaneously assessing effectiveness of interventions with research rigour. So what? Through use of quasi-experimental or well designed before-after evaluations, in combination with detailed engagement metrics, it is possible to balance assessment of effectiveness and reach to evaluate SNS health promotion.

  20. Integrated plant safety assessment, Systematic Evaluation Program: Dresden Nuclear Power Station, Unit 2 (Docket No. 50-237)

    International Nuclear Information System (INIS)

    1989-10-01

    The US Nuclear Regulatory Commission (NRC) has prepared Supplement 1 to the final Integrated Plant Safety Assessment Report (IPSAR) (NUREG-0823), under the scope of the Systematic Evaluation Program (SEP), for the Commonwealth Edison Company (CECo) Dresden Nuclear Power Station, Unit 2 located in Grundy County, Illinois. The NRC initiated the SEP to provide the framework for reviewing the design of older operating nuclear reactor plants to reconfirm and document their safety. This report documents the review completed by means of the SEP for those issues that required refined engineering evaluations or the continuation of ongoing evaluations subsequent to issuing the final IPSAR for Dresden Unit 2. The review was provided for (1) an assessment of the significance of differences between current technical positions on selected issues and those that existed when Dresden Unit 2 was licensed, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. The final IPSAR and this supplement forms part of the bases for considering the conversion of the existing provisional operating license to a full-term operating license. 83 refs., 9 tabs

  1. Systematic content evaluation and review of measurement properties of questionnaires for measuring self-reported fatigue among older people.

    Science.gov (United States)

    Egerton, Thorlene; Riphagen, Ingrid I; Nygård, Arnhild J; Thingstad, Pernille; Helbostad, Jorunn L

    2015-09-01

    The assessment of fatigue in older people requires simple and user-friendly questionnaires that capture the phenomenon, yet are free from items indistinguishable from other disorders and experiences. This study aimed to evaluate the content, and systematically review and rate the measurement properties of self-report questionnaires for measuring fatigue, in order to identify the most suitable questionnaires for older people. This study firstly involved identification of questionnaires that purport to measure self-reported fatigue, and evaluation of the content using a rating scale developed for the purpose from contemporary understanding of the construct. Secondly, for the questionnaires that had acceptable content, we identified studies reporting measurement properties and rated the methodological quality of those studies according to the COSMIN system. Finally, we extracted and synthesised the results of the studies to give an overall rating for each questionnaire for each measurement property. The protocol was registered with PROSPERO (CRD42013005589). Of the 77 identified questionnaires, twelve were selected for review after content evaluation. Methodological quality varied, and there was a lack of information on measurement error and responsiveness. The PROMIS-Fatigue item bank and short forms perform the best. The FACIT-Fatigue scale, Parkinsons Fatigue Scale, Perform Questionnaire, and Uni-dimensional Fatigue Impact Scale also perform well and can be recommended. Minor modifications to improve performance are suggested. Further evaluation of unresolved measurement properties, particularly with samples including older people, is needed for all the recommended questionnaires.

  2. Evaluating Training Programs for Primary Care Providers in Child/Adolescent Mental Health in Canada: A Systematic Review

    Science.gov (United States)

    Espinet, Stacey; Naqvi, Reza; Lingard, Lorelei; Steele, Margaret

    2018-01-01

    Introduction The need for child/adolescent mental health care in Canada is growing. Primary care can play a key role in filling this gap, yet most providers feel they do not have adequate training. This paper reviews the Canadian literature on capacity building programs in child and adolescent psychiatry for primary care providers, to examine how these programs are being implemented and evaluated to contribute to evidence-based initiatives. Methods A systematic literature review of peer-reviewed published articles of capacity building initiatives in child/adolescent mental health care for primary care practitioners that have been implemented in Canada. Results Sixteen articles were identified that met inclusion criteria. Analysis revealed that capacity building initiatives in Canada are varied but rigorous evaluation methodology is lacking. Primary care providers welcome efforts to increase mental health care capacity and were satisfied with the implementation of most programs. Discussion Objective conclusions regarding the effectiveness of these programs to increase mental health care capacity is challenging given the evaluation methodology of these studies. Conclusion Rigorous evaluation methods are needed to make evidence-based decisions on ways forward to be able to build child/adolescent mental health care capacity in primary care. Outcome measures need to move beyond self-report to more objective measures, and should expand the measurement of patient outcomes to ensure that these initiative are indeed leading to improved care for families. PMID:29662521

  3. Evaluating Training Programs for Primary Care Providers in Child/Adolescent Mental Health in Canada: A Systematic Review.

    Science.gov (United States)

    Gotovac, Sandra; Espinet, Stacey; Naqvi, Reza; Lingard, Lorelei; Steele, Margaret

    2018-04-01

    The need for child/adolescent mental health care in Canada is growing. Primary care can play a key role in filling this gap, yet most providers feel they do not have adequate training. This paper reviews the Canadian literature on capacity building programs in child and adolescent psychiatry for primary care providers, to examine how these programs are being implemented and evaluated to contribute to evidence-based initiatives. A systematic literature review of peer-reviewed published articles of capacity building initiatives in child/adolescent mental health care for primary care practitioners that have been implemented in Canada. Sixteen articles were identified that met inclusion criteria. Analysis revealed that capacity building initiatives in Canada are varied but rigorous evaluation methodology is lacking. Primary care providers welcome efforts to increase mental health care capacity and were satisfied with the implementation of most programs. Objective conclusions regarding the effectiveness of these programs to increase mental health care capacity is challenging given the evaluation methodology of these studies. Rigorous evaluation methods are needed to make evidence-based decisions on ways forward to be able to build child/adolescent mental health care capacity in primary care. Outcome measures need to move beyond self-report to more objective measures, and should expand the measurement of patient outcomes to ensure that these initiative are indeed leading to improved care for families.

  4. Economic evaluations of occupational health interventions from a corporate perspective - A systematic review of methodological quality

    NARCIS (Netherlands)

    Uegaki, K.; Bruijne, M.C. de; Lambeek, L.; Anema, J.R.; Beek, A.J. van der; Mechelen, W. van; Tulder, M.W. van

    2010-01-01

    Objective: Using a standardized quality criteria list, we appraised the methodological quality of economic evaluations of occupational safety and health (OSH) interventions conducted from a corporate perspective. Methods: The primary literature search was conducted in Medline and Embase.

  5. Integrated Plant Safety Assessment, Systematic Evaluation Program, Palisades Plant (Docket No. 50-255)

    International Nuclear Information System (INIS)

    1983-11-01

    This report documents the review completed under the SEP for those issues that required refined engineering evaluations or the continuation of ongoing evaluations after the Final IPSAR for the Palisades Plant was issued. The review has provided for (1) an assessment of the significance of differences between current technical positions on selected safety issues and those that existed when the Palisades Plant was licensed, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety when the supplement to the Final IPSAR and the Safety Evaluation Report for converting the license from a provisional to a full-term license have been issued. The Final IPSAR and its supplement will form part of the bases for considering the conversion of the provisional operating license to a full-term operating license

  6. Radiological and clinical outcomes of novel Ti/PEEK combined spinal fusion cages: a systematic review and preclinical evaluation.

    Science.gov (United States)

    Assem, Yusuf; Mobbs, Ralph J; Pelletier, Matthew H; Phan, Kevin; Walsh, William R

    2017-03-01

    The primary objective of this paper was to provide a systematic review of the available clinical studies of Ti/PEEK combined cages in spinal interbody fusion surgeries, focusing on their radiological and clinical outcomes. A secondary aim was to provide a review and evaluation of the in vitro and preclinical studies reported on Ti/PEEK-coated implants. A systematic search of the literature was performed in March 2015 via three databases: Medline, Embase and Cochrane library. The following key search terms were combined with synonyms to identify relevant articles: "spinal fusion," "PEEK," "titanium" and "cage." The novelty of this intervention translates into a paucity of clinical trials, albeit the results of the seven clinical studies that met the criteria for inclusion are promising. All studies reported rate of fusion as a primary outcome. Two studies reported slightly improved fusion in the experimental Ti/PEEK combination cohort, one study identical fusion (91.7 %) and three studies excellent fusion (96, 100 and 94 %) in the Ti/PEEK cohort, although no differences reached statistical significance. Clinical studies at this early stage demonstrate that Ti/PEEK implants are safe and efficacious, exhibiting similar fusion rates and clinical outcomes compared to the current standard PEEK. There is clinical evidence substantiating the improved radiographic fusion of Ti/PEEK, albeit the differences were not significant. This field is promising, gaining substantial popularity, and further clinical trials are needed in the future to establish Ti/PEEK cages as a mainstay of clinical practice.

  7. Pharmaceutical priority setting and the use of health economic evaluations: a systematic literature review.

    Science.gov (United States)

    Erntoft, Sandra

    2011-06-01

    To investigate which factors and criteria are used in priority setting of pharmaceuticals, in what contexts health economic evaluations are used, and barriers to the use of health economic evaluations at micro, meso, and macro health-care levels. The search for empirical articles was based on the MeSH index (Medical Substance Heading), including the search terms "economic evaluation," "cost-effectiveness analysis," "cost-utility analysis," "cost-benefit analysis," "pharmacoeconomic," AND "drug cost(s)," AND "eligibility determination," AND "decision-making," AND "rationing," AND formulary. The following databases were searched: PubMed, EconLit, Cochrane, Web of Science, CINAHL, and PsycINFO. More than 3100 studies were identified, 31 of which were included in this review. The use of health economic evaluations at all three health-care levels was investigated in three countries (United States [US], United Kingdom [UK], and Sweden). Postal and telephone survey methods dominated (n = 17) followed by interviews (n = 13), document analysis (n = 10), and observations of group deliberations (n = 9). The cost-effectiveness criterion was most important at the macro level. A number of contextual uses of health economic evaluations were identified, including importantly the legitimizing of decisions, structuring the priority-setting process, and requesting additional budgets to finance expensive pharmaceuticals. Factors that seem to support the increased use of health economic evaluations are well-developed frameworks for evaluations, the presence of health economic skills, and an explicit priority-setting process. Differences in how economic evaluations are used at macro, meso, and micro levels are attributed to differences in the preconditions at each level. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  8. A Systematic Approach for Evaluating BPM Systems: Case Studies on Open Source and Proprietary Tools

    OpenAIRE

    Delgado , Andrea; Calegari , Daniel; Milanese , Pablo; Falcon , Renatta; García , Esteban

    2015-01-01

    Part 3: Examples and Case Studies; International audience; Business Process Management Systems (BPMS) provide support for modeling, developing, deploying, executing and evaluating business processes in an organization. Selecting a BPMS is not a trivial task, not only due to the many existing alternatives, both in the open source and proprietary realms, but also because it requires a thorough evaluation of its capabilities, contextualizing them in the organizational environment in which they w...

  9. A systematic review of evaluated suicide prevention programs targeting indigenous youth.

    Science.gov (United States)

    Harlow, Alyssa F; Bohanna, India; Clough, Alan

    2014-01-01

    Indigenous young people have significantly higher suicide rates than their non-indigenous counterparts. There is a need for culturally appropriate and effective suicide prevention programs for this demographic. This review assesses suicide prevention programs that have been evaluated for indigenous youth in Australia, Canada, New Zealand, and the United States. The databases MEDLINE and PsycINFO were searched for publications on suicide prevention programs targeting indigenous youth that include reports on evaluations and outcomes. Program content, indigenous involvement, evaluation design, program implementation, and outcomes were assessed for each article. The search yielded 229 articles; 90 abstracts were assessed, and 11 articles describing nine programs were reviewed. Two Australian programs and seven American programs were included. Programs were culturally tailored, flexible, and incorporated multiple-levels of prevention. No randomized controlled trials were found, and many programs employed ad hoc evaluations, poor program description, and no process evaluation. Despite culturally appropriate content, the results of the review indicate that more controlled study designs using planned evaluations and valid outcome measures are needed in research on indigenous youth suicide prevention. Such changes may positively influence the future of research on indigenous youth suicide prevention as the outcomes and efficacy will be more reliable.

  10. Evaluating test-retest reliability in patient-reported outcome measures for older people: A systematic review.

    Science.gov (United States)

    Park, Myung Sook; Kang, Kyung Ja; Jang, Sun Joo; Lee, Joo Yun; Chang, Sun Ju

    2018-03-01

    This study aimed to evaluate the components of test-retest reliability including time interval, sample size, and statistical methods used in patient-reported outcome measures in older people and to provide suggestions on the methodology for calculating test-retest reliability for patient-reported outcomes in older people. This was a systematic literature review. MEDLINE, Embase, CINAHL, and PsycINFO were searched from January 1, 2000 to August 10, 2017 by an information specialist. This systematic review was guided by both the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and the guideline for systematic review published by the National Evidence-based Healthcare Collaborating Agency in Korea. The methodological quality was assessed by the Consensus-based Standards for the selection of health Measurement Instruments checklist box B. Ninety-five out of 12,641 studies were selected for the analysis. The median time interval for test-retest reliability was 14days, and the ratio of sample size for test-retest reliability to the number of items in each measure ranged from 1:1 to 1:4. The most frequently used statistical methods for continuous scores was intraclass correlation coefficients (ICCs). Among the 63 studies that used ICCs, 21 studies presented models for ICC calculations and 30 studies reported 95% confidence intervals of the ICCs. Additional analyses using 17 studies that reported a strong ICC (>0.09) showed that the mean time interval was 12.88days and the mean ratio of the number of items to sample size was 1:5.37. When researchers plan to assess the test-retest reliability of patient-reported outcome measures for older people, they need to consider an adequate time interval of approximately 13days and the sample size of about 5 times the number of items. Particularly, statistical methods should not only be selected based on the types of scores of the patient-reported outcome measures, but should also be described clearly in

  11. Treatment of Internet gaming disorder: An international systematic review and CONSORT evaluation.

    Science.gov (United States)

    King, Daniel L; Delfabbro, Paul H; Wu, Anise M S; Doh, Young Yim; Kuss, Daria J; Pallesen, Ståle; Mentzoni, Rune; Carragher, Natacha; Sakuma, Hiroshi

    2017-06-01

    Treatment services for Internet gaming disorder are becoming increasingly prevalent worldwide, particularly in East Asia. This international systematic review was designed to appraise the quality standards of the gaming disorder treatment literature, a task previously undertaken by King et al. (2011) prior to the inclusion of Internet gaming disorder in Section III of the DSM-5 and 'Gaming disorder' in the draft ICD-11. The reporting quality of 30 treatment studies conducted from 2007 to 2016 was assessed. Reporting quality was defined according to the 2010 Consolidating Standards of Reporting Trials (CONSORT) statement. The results reaffirmed previous criticisms of these trials, namely: (a) inconsistencies in the definition, diagnosis, and measurement of disordered use; (b) lack of randomization and blinding; (c) lack of controls; and (d) insufficient information on recruitment dates, sample characteristics, and effect sizes. Although cognitive-behavioral therapy has a larger evidence base than other therapies, it remains difficult to make definitive statements on its benefits. Study design quality has not improved over the last decade, indicating a need for greater consistency and standardization in this area. Continuing international efforts to understand the core psychopathology of gaming disorder are vital to developing a model of best practice in treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. A Systematic Evaluation of Blood Serum and Plasma Pre-Analytics for Metabolomics Cohort Studies

    Directory of Open Access Journals (Sweden)

    Elodie Jobard

    2016-12-01

    Full Text Available The recent thriving development of biobanks and associated high-throughput phenotyping studies requires the elaboration of large-scale approaches for monitoring biological sample quality and compliance with standard protocols. We present a metabolomic investigation of human blood samples that delineates pitfalls and guidelines for the collection, storage and handling procedures for serum and plasma. A series of eight pre-processing technical parameters is systematically investigated along variable ranges commonly encountered across clinical studies. While metabolic fingerprints, as assessed by nuclear magnetic resonance, are not significantly affected by altered centrifugation parameters or delays between sample pre-processing (blood centrifugation and storage, our metabolomic investigation highlights that both the delay and storage temperature between blood draw and centrifugation are the primary parameters impacting serum and plasma metabolic profiles. Storing the blood drawn at 4 °C is shown to be a reliable routine to confine variability associated with idle time prior to sample pre-processing. Based on their fine sensitivity to pre-analytical parameters and protocol variations, metabolic fingerprints could be exploited as valuable ways to determine compliance with standard procedures and quality assessment of blood samples within large multi-omic clinical and translational cohort studies.

  13. Comparison Groups in Yoga Research: A Systematic Review and Critical Evaluation of the Literature

    Science.gov (United States)

    Groessl, Erik; Maiya, Meghan; Sarkin, Andrew; Eisen, Susan V.; Riley, Kristen; Elwy, A. Rani

    2014-01-01

    Objectives Comparison groups are essential for accurate testing and interpretation of yoga intervention trials. However, selecting proper comparison groups is difficult because yoga comprises a very heterogeneous set of practices and its mechanisms of effect have not been conclusively established. Methods We conducted a systematic review of the control and comparison groups used in published randomized controlled trials (RCTs) of yoga. Results We located 128 RCTs that met our inclusion criteria; of these, 65 included only a passive control and 63 included at least one active comparison group. Primary comparison groups were physical exercise (43%), relaxation/meditation (20%), and education (16%). Studies rarely provided a strong rationale for choice of comparison. Considering year of publication, the use of active controls in yoga research appears to be slowly increasing over time. Conclusions Given that yoga has been established as a potentially powerful intervention, future research should use active control groups. Further, care is needed to select comparison conditions that help to isolate the specific mechanisms of yoga’s effects. PMID:25440384

  14. Risk evaluations of aging: Procedures guide for an age-dependent PSA with emphasis on prioritization and sensitivity studies

    International Nuclear Information System (INIS)

    Vesely, W.E.

    1991-01-01

    Based on the previous work which has been performed in the project, a procedures guide is being developed for carrying out an age-dependent probabilistic safety assessment (PSA) for evaluating the core damage frequency with aging effects explicitly treated. A PSA is basically a Level 1 Probabilistic Risk Assessment (PRA). The emphasis of the guide is on prioritization and sensitivity studies. Focus is also on active components although consideration of aging effects in passive components is also treated. The guide is intended to become a NUREG/CR and is the first of three volumes which are being developed. The following topics with demonstrations and applications are described in the presentation: (1) the age-dependent PSA versus the standard PSA; (2) component reliability models used in an age-dependent PSA; (3) approaches for transforming a PSA into an age-dependent PSA; (4) application of an age-dependent PSA; (5) using a PSA to evaluate the risk effects from aging passive components; (6) evaluation of the risk importance of passive components; (7) prioritizations of aging contributors; (8) evaluations of test and maintenance effectiveness; and (9) sensitivity studies and uncertainty analyses of aging effects

  15. Difficulty Systematized Evaluation of Vocal Folds Exposure in Microsurgery of the Larynx

    Directory of Open Access Journals (Sweden)

    Ballin, Annelyse Cristine

    2010-09-01

    Full Text Available Introduction: Several studies addressing preoperative factors that predict difficulty of endotracheal intubation graduated by anesthesiologists, for the scale of the Cormack-Lehane. These parameters were evaluated for the difficulty of location of the laryngoscope in microsurgery of the larynx. There is not a standard scale of difficulty targeted to surgeons of the larynx. Objective: Create a standard scale of difficulty leasing the laryngoscope during microsurgery of the larynx, with a focus on exposure of the vocal folds (vocal cords to evaluate which clinical parameters predict difficulty of exposure of their vocal folds and verify the improvement of laryngeal exposure with the hanger of the laryngoscope. Method: A prospective randomized study, 57 patients undergoing laryngeal microsurgery. The preoperative parameters were evaluated: three epidemiological data, two of history and 13 physical examination. Intraoperatively: the anesthesiologist evaluated the Cormack-Lehane score and the surgeon evaluated according to the proposed scale, before and after placement of the hanger. Results and Conclusion: Several parameters showed sensitivity, specificity, positive predictive value for high inadequate exposure of the larynx. But only distance hiomentual <6.05 cm (p = 0.003 and 2 classes of Cormack-Lehane (p = 0.04 with statistical significance and high sensitivity of 100% and 81% respectively. The use of the hanger of laryngoscope laryngeal exposure improved significantly (p = 0.04. The proposed scale standardizes the visualization and grades the difficulty of exposure of their vocal folds, facilitating comparisons between studies and communication between otolaryngologists.

  16. Systematic Heuristic Evaluation of Computerized Consultation Order Templates: Clinicians' and Human Factors Engineers' Perspectives.

    Science.gov (United States)

    Savoy, April; Patel, Himalaya; Flanagan, Mindy E; Weiner, Michael; Russ, Alissa L

    2017-08-01

    We assessed the usability of consultation order templates and identified problems to prioritize in design efforts for improving referral communication. With a sample of 26 consultation order templates, three evaluators performed a usability heuristic evaluation. The evaluation used 14 domain-independent heuristics and the following three supplemental references: 1 new domain-specific heuristic, 6 usability goals, and coded clinicians' statements regarding ease of use for 10 sampled templates. Evaluators found 201 violations, a mean of 7.7 violations per template. Minor violations outnumbered major violations almost twofold, 115 (57%) to 62 (31%). Approximately 68% of violations were linked to 5 heuristics: aesthetic and minimalist design (17%), error prevention (16%), consistency and standards (14%), recognition rather than recall (11%), and meet referrers' information needs (10%). Severe violations were attributed mostly to meet referrers' information needs and recognition rather than recall. Recorded violations yielded potential negative consequences for efficiency, effectiveness, safety, learnability, and utility. Evaluators and clinicians demonstrated 80% agreement in usability assessment. Based on frequency and severity of usability heuristic violations, the consultation order templates reviewed may impede clinical efficiency and risk patient safety. Results support the following design considerations: communicate consultants' requirements, facilitate information seeking, and support communication. While the most frequent heuristic violations involved interaction design and presentation, the most severe violations lacked information desired by referring clinicians. Violations related to templates' inability to support referring clinicians' information needs had the greatest potential negative impact on efficiency and safety usability goals. Heuristics should be prioritized in future design efforts.

  17. A systematic review and evaluation of inhibitory stimulus control procedures as a treatment for stereotyped behavior among individuals with autism.

    Science.gov (United States)

    Lydon, Sinéad; Moran, Laura; Healy, Olive; Mulhern, Teresa; Enright Young, Kerie

    2017-11-01

    Stereotypy is pervasive among persons with autism and may impact negatively on social inclusion and learning. The implementation of resource-intensive behavioral interventions to decrease these behaviors has been questioned. Inhibitory stimulus control procedures (ISCPs) comprise a type of antecedent-based intervention that has been proposed as an effective treatment approach for stereotypy but has received limited research attention to date. The current systematic review sought to examine and synthesize the literature reporting applications of ISCPs in the treatment of stereotypy among persons with autism. Treatment outcomes were analyzed quantitatively and the status of ISCPs as evidence-based practice was evaluated in accordance with the National Autism Center's National Standards Report guidelines. A total of 11 studies were reviewed with results indicating that ISCPs constituted an emerging treatment for the stereotypy exhibited by persons with autism. ISCPs comprise a promising intervention for stereotyped behavior but further research is required.

  18. I and C upgrades resulting from the systematic evaluation program carried out at the Central Nuclear Jose Cabrera

    International Nuclear Information System (INIS)

    Humphrey, J.C.

    1985-01-01

    Central Nuclear Jose Cabrera, also known as Zorita, is a 160 MWe nuclear power plant owned and operated by UNION ELECTRICA-FENOSA, S.A. The plant was supplied by Westinghouse Electric Corporation and commissioned in 1968. It features a unique one loop Pressurized Water Reactor design. The Spanish Licensing Authorities requested C.N. Jose Cabrera to carry out a review of their plant. The main objectives were to reassess the safety adequacy of the operating systems, provide a documented comparison of the plant design versus present day criteria and establish a rationale for departures. Another important objective was to provide prompt identification of any significant deficiency. The review known as phase 1 of the C.N. Jose Cabrera Systematic Evaluation Program, was completed and documented by April 1980

  19. SustainPro - A tool for systematic process analysis, generation and evaluation of sustainable design alternatives

    DEFF Research Database (Denmark)

    Carvalho, Ana; Matos, Henrique A.; Gani, Rafiqul

    2013-01-01

    the user through the necessary steps according to work-flow of the implemented methodology. At the end the design alternatives, are evaluated using environmental impact assessment tools and safety indices. The extended features of the methodology incorporate Life Cycle Assessment analysis and economic....... The software tool is based on the implementation of an extended systematic methodology for sustainable process design (Carvalho et al. 2008 and Carvalho et al. 2009). Using process information/data such as the process flowsheet, the associated mass / energy balance data and the cost data, SustainPro guides...... analysis. The application and the main features of SustainPro are illustrated through a case study of ß-Galactosidase production....

  20. Reinforcer magnitude and rate dependency: evaluation of resistance-to-change mechanisms.

    Science.gov (United States)

    Pinkston, Jonathan W; Ginsburg, Brett C; Lamb, Richard J

    2014-10-01

    Under many circumstances, reinforcer magnitude appears to modulate the rate-dependent effects of drugs such that when schedules arrange for relatively larger reinforcer magnitudes rate dependency is attenuated compared with behavior maintained by smaller magnitudes. The current literature on resistance to change suggests that increased reinforcer density strengthens operant behavior, and such strengthening effects appear to extend to the temporal control of behavior. As rate dependency may be understood as a loss of temporal control, the effects of reinforcer magnitude on rate dependency may be due to increased resistance to disruption of temporally controlled behavior. In the present experiments, pigeons earned different magnitudes of grain during signaled components of a multiple FI schedule. Three drugs, clonidine, haloperidol, and morphine, were examined. All three decreased overall rates of key pecking; however, only the effects of clonidine were attenuated as reinforcer magnitude increased. An analysis of within-interval performance found rate-dependent effects for clonidine and morphine; however, these effects were not modulated by reinforcer magnitude. In addition, we included prefeeding and extinction conditions, standard tests used to measure resistance to change. In general, rate-decreasing effects of prefeeding and extinction were attenuated by increasing reinforcer magnitudes. Rate-dependent analyses of prefeeding showed rate-dependency following those tests, but in no case were these effects modulated by reinforcer magnitude. The results suggest that a resistance-to-change interpretation of the effects of reinforcer magnitude on rate dependency is not viable.

  1. Systematic review of economic evaluations of vaccination programs in mainland China: Are they sufficient to inform decision making?

    Science.gov (United States)

    Pan, Xiong-Fei; Griffiths, Ulla K; Pennington, Mark; Yu, Hongjie; Jit, Mark

    2015-11-17

    The purpose of the study was to systematically review economic evaluations of vaccine programs conducted in mainland China. We searched for economic evaluations of vaccination in China published prior to August 3, 2015 in eight English-language and three Chinese-language databases. Each article was appraised against the 19-item Consensus on Health Economic Criteria list (CHEC-list). We found 23 papers evaluating vaccines against hepatitis B (8 articles), Streptococcus pneumoniae (5 articles), human papillomavirus (3 articles), Japanese encephalitis (2 articles), rotavirus (2 articles), hepatitis A (1 article), Enterovirus 71 (1 article) and influenza (1 article). Studies conformed to a mean of 12 (range: 6-18) items in the CHEC-list criteria. Five of six Chinese-language articles conformed to fewer than half of the 19 criteria items. The main criteria that studies failed to conform to included: inappropriate measurement (20 articles) and valuation (18 articles) of treatment and/or vaccination costs, no discussion about distributional implications (18 articles), missing major health outcomes (14 articles), no discussion about generalizability to other contexts (14 articles), and inadequate sensitivity analysis (13 articles). In addition, ten studies did not include major cost components of vaccination programs, and nine did not report outcomes in terms of life years even in cases where QALYs or DALYs were calculated. Only 13 studies adopted a societal perspective for analysis. All studies concluded that the appraised vaccination programs were cost-effective except for one evaluation of universal 7-valent pneumococcal conjugate vaccine (PCV-7) in children. However, three of the five studies on PCV-7 showed poor overall quality, and the number of studies on vaccines other than hepatitis B vaccine and PCV-7 was limited. In conclusion, major methodological flaws and reporting problems exist in current economic evaluations of vaccination programs in China. Local

  2. Quality of life instruments for economic evaluations in health and social care for older people: a systematic review.

    Science.gov (United States)

    Makai, Peter; Brouwer, Werner B F; Koopmanschap, Marc A; Stolk, Elly A; Nieboer, Anna P

    2014-02-01

    Gaining health may not be the main goal of healthcare services aimed at older people, which may (also) seek to improve wellbeing. This emphasizes the need of finding appropriate outcome measures for economic evaluation of such services, particularly in long-term care, capturing more than only health-related quality of life (HrQol). This review assesses the usefulness of HrQol and wellbeing instruments for economic evaluations specifically aimed at older people, focusing on generic and preference-based questionnaires measuring wellbeing in particular. We systematically searched six databases and extracted instruments used to assess HrQol and wellbeing outcomes. Instruments were compared based on their usefulness for economic evaluation of services aimed at older people (dimensions measured, availability of utility scores, extent of validation). We identified 487 articles using 34 generic instruments: 22 wellbeing (two of which were preference-based) and 11 HrQol instruments. While standard HrQol instruments measure physical, social and psychological dimensions, wellbeing instruments contain additional dimensions such as purpose in life and achievement, security, and freedom. We found four promising wellbeing instruments for inclusion in economic evaluation: Ferrans and Powers QLI and the WHO-Qol OLD, ICECAP-O and the ASCOT. Ferrans and Powers QLI and the WHO-Qol OLD are widely validated but lack preference-weights while for ICECAP-O and the ASCOT preference-weights are available, but are less widely validated. Until preference-weights are available for the first two instruments, the ICECAP-O and the ASCOT currently appear to be the most useful instruments for economic evaluations in services aimed at older people. Their limitations are that (1) health dimensions may be captured only partially and (2) the instruments require further validation. Therefore, we currently recommend using the ICECAP-O or the ASCOT alongside the EQ-5D or SF-6D when evaluating interventions

  3. Determining of factors influencing the success and failure of hospital information system and their evaluation methods: a systematic review.

    Science.gov (United States)

    Sadoughi, Farahnaz; Kimiafar, Khalil; Ahmadi, Maryam; Shakeri, Mohammad Taghi

    2013-12-01

    Nowadays, using new information technology (IT) has provided remarkable opportunities to decrease medical errors, support health care specialist, increase the efficiency and even the quality of patient's care and safety. The purpose of this study was the identification of Hospital Information System (HIS) success and failure factors and the evaluation methods of these factors. This research emphasizes the need to a comprehensive evaluation of HISs which considers a wide range of success and failure factors in these systems. We searched for relevant English language studies based on keywords in title and abstract, using PubMed, Ovid Medline (by applying MeSH terms), Scopus, ScienceDirect and Embase (earliest entry to march 17, 2012). Studies which considered success models and success or failure factors, or studied the evaluation models of HISs and the related ones were chosen. Since the studies used in this systematic review were heterogeneous, the combination of extracted data was carried out by using narrative synthesis method. We found 16 articles which required detailed analysis. Finally, the suggested framework includes 12 main factors (functional, organizational, behavioral, cultural, management, technical, strategy, economy, education, legal, ethical and political factors), 67 sub factors, and 33 suggested methods for the evaluation of these sub factors. The results of the present research indicates that the emphasis of the HIS evaluation moves from technical subjects to human and organizational subjects, and from objective to subjective issues. Therefore, this issue entails more familiarity with more qualitative evaluation methods. In most of the reviewed studies, the main focus has been laid on the necessity of using multi-method approaches and combining methods to obtain more comprehensive and useful results.

  4. Psoriasis treatment and management - a systematic review of full economic evaluations.

    Science.gov (United States)

    Hamilton, M P; Ntais, D; Griffiths, C E M; Davies, L M

    2015-03-01

    Psoriasis frequently requires lifetime control and current therapies vary significantly in price. High-quality economic evaluations are necessary to determine if higher-cost treatments are value for money. This review aims to identify the cost-effectiveness of psoriasis care (whether more expensive interventions are associated with savings in health care and psoriasis management and/or improve patients' health); assess the level of uncertainty and transferability of this evidence to policy and practice; and, identify future research needs. Searches of electronic databases Embase, MEDLINE and NHS EED for full economic evaluations were conducted in January 2012 (updated April 2014). Included articles were screened, selected and critically appraised using predefined inclusion criteria and data extraction forms: 1355 articles were identified; 37 papers reporting 71 comparisons met the inclusion criteria. Treatments evaluated were systemic (n = 45), topical (n = 22), phototherapies (n = 14) and combination (n = 4). Despite a significant number of recent economic evaluations, the cost-effectiveness of all therapies remains unclear. This uncertainty arises from a diversity in settings, perspective and design. Economic evaluations were constrained by limited availability of high-quality short- and long-term head-to-head comparisons of the effectiveness, safety and adherence of different interventions. The economic evidence is dominated by comparisons of interventions to placebo, with implicit comparisons of different therapies. There is a lack of evaluations of service model innovations to deliver complex packages of care for psoriasis. Primary and secondary integrated clinical and economic research is needed to address the limitations and to identify patient preferences and barriers/facilitators to treatment. © 2014 British Association of Dermatologists.

  5. A systematic review of economic evaluations of treatments for patients with epilepsy.

    Science.gov (United States)

    Wijnen, Ben F M; van Mastrigt, Ghislaine A P G; Evers, Silvia M A A; Gershuni, Olga; Lambrechts, Danielle A J E; Majoie, Marian H J M; Postulart, Debby; Aldenkamp, Bert A P; de Kinderen, Reina J A

    2017-05-01

    The increasing number of treatment options and the high costs associated with epilepsy have fostered the development of economic evaluations in epilepsy. It is important to examine the availability and quality of these economic evaluations and to identify potential research gaps. As well as looking at both pharmacologic (antiepileptic drugs [AEDs]) and nonpharmacologic (e.g., epilepsy surgery, ketogenic diet, vagus nerve stimulation) therapies, this review examines the methodologic quality of the full economic evaluations included. Literature search was performed in MEDLINE, EMBASE, NHS Economic Evaluation Database (NHS EED), Econlit, Web of Science, and CEA Registry. In addition, Cochrane Reviews, Cochrane DARE and Cochrane Health Technology Assessment Databases were used. To identify relevant studies, predefined clinical search strategies were combined with a search filter designed to identify health economic studies. Specific search strategies were devised for the following topics: (1) AEDs, (2) patients with cognitive deficits, (3) elderly patients, (4) epilepsy surgery, (5) ketogenic diet, (6) vagus nerve stimulation, and (7) treatment of (non)convulsive status epilepticus. A total of 40 publications were included in this review, 29 (73%) of which were articles about pharmacologic interventions. Mean quality score of all articles on the Consensus Health Economic Criteria (CHEC)-extended was 81.8%, the lowest quality score being 21.05%, whereas five studies had a score of 100%. Looking at the Consolidated Health Economic Evaluation Reporting Standards (CHEERS), the average quality score was 77.0%, the lowest being 22.7%, and four studies rated as 100%. There was a substantial difference in methodology in all included articles, which hampered the attempt to combine information meaningfully. Overall, the methodologic quality was acceptable; however, some studies performed significantly worse than others. The heterogeneity between the studies stresses the need to

  6. Evaluation of Cross-Cultural Adaptation and Measurement Properties of STarT Back Screening Tool: A Systematic Review.

    Science.gov (United States)

    Al Zoubi, Fadi M; Eilayyan, Owis; Mayo, Nancy E; Bussières, André E

    2017-10-01

    The purpose of this systematic review was to investigate the extent to which the STarT Back Screening Tool (SBST) has been evaluated for (1) the quality of translation of evidence for cross-cultural adaptation and (2) the measurement properties in languages other than English. A systematic search of 8 databases, including Medline, Embase, CINAHL, PsycINFO, AMED, Scopus, PubMed, and Web of Science, was performed. Electronic databases were searched for the period between 2008 and December 27, 2016. We included studies related to cross-cultural adaptation, including translation and assessment of the measurement properties of SBST. Study selection, translation, methodologic and quality assessments, and data extraction were performed independently by 2 reviewers. Of the 1566 citations retrieved, 17 studies were admissible, representing 11 different SBST versions in 10 languages. The quadratic weighted κ statistics of the 2 reviewers, for the translation, methodologic assessment, and quality assessment were 0.85, 0.76, and 0.83, respectively. For translation, only 2 versions (Belgian-French and Mandarin) fulfilled all requirements. None of the versions had tested all the measurement properties, and when performed, these were found to have been conducted inadequately. With regard to quality assessment, overall, the included versions had a "Poor" total summary score except 2 (Persian and Swiss-German), which were rated as "Fair." Few versions fully met the standard criteria for valid translation, and none of the versions tested all the measurement properties. There is a clear need for more accurate cross-cultural adaptation of SBST and greater attention to the quality of psychometric evaluation of the adapted versions of SBST. At this time, caution is recommended when using SBST in languages other than English. Copyright © 2017. Published by Elsevier Inc.

  7. Anatomy of the portal and hepatic veins of the dog: a basis for systematic evaluation of the liver by ultrasonography

    International Nuclear Information System (INIS)

    Carlisle, C.H.; Wu, J.X.; Heath, T.J.

    1995-01-01

    The objective of this study was to define, in detail, the anatomy of the portal and hepatic veins in the dog in order to establish a procedure for the systematic evaluation of the liver by ultrasonography. Anatomical details were obtained from the formalin fixed livers of ten dogs. The hepatic and portal veins were removed intact from these livers so that a detailed pattern of distribution could be established and the numbers of branches could be counted. Silastic casts were also made of the hepatic and portal veins of two livers, one in situ and one in which it had been removed. The former was to enable the relationship of the portal to the hepatic veins to be established as closely as possible within the animal and the other to provide a model of the distribution of each venous system within the liver. Contrast medium was infused into two other livers and radiographs taken to establish the relationship of each branch to each lobe. It was found that there was a consistent pattern of venous branching to each lobe of the liver in the dog with little variation between individual specimens. All liver lobes contained definite venous branches so that the left lateral and medial, quadrate, right medial and lateral, caudate and papillary veins could be distinguished in each venous system. We believe that an appreciation of this venous distribution will aid in the systematic evaluation of the liver during ultrasonography by enabling identification of each liver lobe. It should be of value for differentiating portal from hepatic veins and veins from dilated bile ducts

  8. A systematic approach to the modelling of measurements for uncertainty evaluation

    International Nuclear Information System (INIS)

    Sommer, K D; Weckenmann, A; Siebert, B R L

    2005-01-01

    The evaluation of measurement uncertainty is based on both, the knowledge about the measuring process and the quantities which influence the measurement result. The knowledge about the measuring process is represented by the model equation which expresses the interrelation between the measurand and the input quantities. Therefore, the modelling of the measurement is a key element of modern uncertainty evaluation. A modelling concept has been developed that is based on the idea of the measuring chain. It gets on with only a few generic model structures. From this concept, a practical stepwise procedure has been derived

  9. Structural, mechanical and chemical evaluation of molar-incisor hypomineralization-affected enamel: A systematic review.

    Science.gov (United States)

    Elhennawy, Karim; Manton, David John; Crombie, Felicity; Zaslansky, Paul; Radlanski, Ralf J; Jost-Brinkmann, Paul-Georg; Schwendicke, Falk

    2017-11-01

    To systematically assess and contrast reported differences in microstructure, mineral density, mechanical and chemical properties between molar-incisor-hypomineralization-affected (MIH) enamel and unaffected enamel. Studies on extracted human teeth, clinically diagnosed with MIH, reporting on the microstructure, mechanical properties or the chemical composition and comparing them to unaffected enamel were reviewed. Electronic databases (PubMed, Embase and Google Scholar) were screened; hand searches and cross-referencing were also performed. Twenty-two studies were included. Fifteen studies on a total of 201 teeth investigated the structural properties, including ten (141 teeth) on microstructure and seven (60 teeth) on mineral density; six (29 teeth) investigated the mechanical properties and eleven (87 teeth) investigated the chemical properties of MIH-affected enamel and compared them to unaffected enamel. Studies unambiguously found a reduction in mineral quantity and quality (reduced Ca and P content), reduction of hardness and modulus of elasticity (also in the clinically sound-appearing enamel bordering the MIH-lesion), an increase in porosity, carbon/carbonate concentrations and protein content compared to unaffected enamel. were ambiguous with regard to the extent of the lesion through the enamel to the enamel-dentin junction, the Ca/P ratio and the association between clinical appearance and defect severity. There is an understanding of the changes related to MIH-affected enamel. The association of these changes with the clinical appearance and resulting implications for clinical management are unclear. MIH-affected enamel is greatly different from unaffected enamel. This has implications for management strategies. The possibility of correlating the clinical appearance of MIH-affected enamel with the severity of enamel changes and deducing clinical concepts (risk stratification etc.) is limited. Crown Copyright © 2017. Published by Elsevier Ltd. All

  10. The effect of interior lead hazard controls on children's blood lead concentrations: a systematic evaluation.

    Science.gov (United States)

    Haynes, Erin; Lanphear, Bruce P; Tohn, Ellen; Farr, Nick; Rhoads, George G

    2002-01-01

    Dust control is often recommended to prevent children's exposure to residential lead hazards, but the effect of these controls on children's blood lead concentrations is uncertain. We conducted a systematic review of randomized, controlled trials of low-cost, lead hazard control interventions to determine the effect of lead hazard control on children's blood lead concentration. Four trials met the inclusion criteria. We examined mean blood lead concentration and elevated blood lead concentrations (> or = 10 microg/dL, > or = 15 microg/dL, and > or = 20 microg/dL) and found no significant differences in mean change in blood lead concentration for children by random group assignment (children assigned to the intervention group compared with those assigned to the control group). We found no significant difference between the intervention and control groups in the percentage of children with blood lead > or = 10 microg/dL, 29% versus 32% [odds ratio (OR), 0.85; 95% confidence interval (CI), 0.56-1.3], but there was a significant difference in the percentage of children with blood lead > or = 15 microg/dL between the intervention and control groups, 6% versus 14% (OR, 0.40; 95% CI, 0.21-0.80) and in the percentage of children with blood lead > or = 20 microg/dL between the intervention and control groups, 2% versus 6% (OR, 0.29; 95% CI, 0.10-0.85). We conclude that although low-cost, interior lead hazard control was associated with 50% or greater reduction in the proportion of children who had blood lead concentrations exceeding 15 microg/dL and > or = 20 microg/dL, there was no substantial effect on mean blood lead concentration.

  11. Calcification of the mitral valve and annulus: systematic evaluation of effects on valve anatomy and function.

    Science.gov (United States)

    Movva, Rajesh; Murthy, Kinnari; Romero-Corral, Abel; Seetha Rammohan, Harish Raj; Fumo, Peter; Pressman, Gregg S

    2013-10-01

    Mitral annular calcification (MAC) is common in chronic kidney disease. It is associated with cardiovascular events and can cause valvular dysfunction, but it has not been systematically characterized. The aim of this prospective study was to assess the prevalence and distribution of MAC, its effects on leaflet motion, and its association with mitral stenosis and mitral regurgitation (MR) in a hemodialysis population. Echocardiograms were obtained in 75 consecutive hemodialysis outpatients. MAC extent and distribution were graded semiquantitatively using two-dimensional and three-dimensional echocardiography. Associations with the presence and severity of mitral stenosis and MR were explored. The mean age was 60 ± 14 years; 60% were men, and 87% were African American. MAC was present in 64% (moderate to severe in 48%). Calcium extended more than halfway onto the leaflet in 37% and beyond the annulus in 40%. Leaflet motion was restricted in 37%. Mitral stenosis was present in 28%, and the extent of calcification was associated with mean mitral valve gradient (P < .0001). MR was prevalent (present in 81%) but was severe in none. The severity of MAC was greater in patients with moderate MR than in those with no or mild MR (P = .04). Three-dimensional analysis suggested an uneven distribution of annular calcium; the middle and lateral anterior segments were less often calcified than the anterior-medial or posterior segments. Calcification in any annular segment was highly associated with restricted motion of the attached leaflet segment. MAC is common and often extensive in hemodialysis patients. Calcium may be unevenly distributed among the annular segments. When present, annular calcification reduces the angle of leaflet opening and can cause valvular dysfunction. Copyright © 2013 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

  12. Systematic review of ERP and fMRI studies investigating inhibitory control and error processing in people with substance dependence and behavioural addictions

    Science.gov (United States)

    Luijten, Maartje; Machielsen, Marise W.J.; Veltman, Dick J.; Hester, Robert; de Haan, Lieuwe; Franken, Ingmar H.A.

    2014-01-01

    Background Several current theories emphasize the role of cognitive control in addiction. The present review evaluates neural deficits in the domains of inhibitory control and error processing in individuals with substance dependence and in those showing excessive addiction-like behaviours. The combined evaluation of event-related potential (ERP) and functional magnetic resonance imaging (fMRI) findings in the present review offers unique information on neural deficits in addicted individuals. Methods We selected 19 ERP and 22 fMRI studies using stop-signal, go/no-go or Flanker paradigms based on a search of PubMed and Embase. Results The most consistent findings in addicted individuals relative to healthy controls were lower N2, error-related negativity and error positivity amplitudes as well as hypoactivation in the anterior cingulate cortex (ACC), inferior frontal gyrus and dorsolateral prefrontal cortex. These neural deficits, however, were not always associated with impaired task performance. With regard to behavioural addictions, some evidence has been found for similar neural deficits; however, studies are scarce and results are not yet conclusive. Differences among the major classes of substances of abuse were identified and involve stronger neural responses to errors in individuals with alcohol dependence versus weaker neural responses to errors in other substance-dependent populations. Limitations Task design and analysis techniques vary across studies, thereby reducing comparability among studies and the potential of clinical use of these measures. Conclusion Current addiction theories were supported by identifying consistent abnormalities in prefrontal brain function in individuals with addiction. An integrative model is proposed, suggesting that neural deficits in the dorsal ACC may constitute a hallmark neurocognitive deficit underlying addictive behaviours, such as loss of control. PMID:24359877

  13. Communication and support from health-care professionals to families, with dependent children, following the diagnosis of parental life-limiting illness: A systematic review.

    Science.gov (United States)

    Fearnley, Rachel; Boland, Jason W

    2017-03-01

    Communication between parents and their children about parental life-limiting illness is stressful. Parents want support from health-care professionals; however, the extent of this support is not known. Awareness of family's needs would help ensure appropriate support. To find the current literature exploring (1) how parents with a life-limiting illness, who have dependent children, perceive health-care professionals' communication with them about the illness, diagnosis and treatments, including how social, practical and emotional support is offered to them and (2) how this contributes to the parents' feelings of supporting their children. A systematic literature review and narrative synthesis. Embase, MEDLINE, PsycINFO, CINAHL and ASSIA ProQuest were searched in November 2015 for studies assessing communication between health-care professionals and parents about how to talk with their children about the parent's illness. There were 1342 records identified, five qualitative studies met the inclusion criteria (55 ill parents, 11 spouses/carers, 26 children and 16 health-care professionals). Parents wanted information from health-care professionals about how to talk to their children about the illness; this was not routinely offered. Children also want to talk with a health-care professional about their parents' illness. Health-care professionals are concerned that conversations with parents and their children will be too difficult and time-consuming. Parents with a life-limiting illness want support from their health-care professionals about how to communicate with their children about the illness. Their children look to health-care professionals for information about their parent's illness. Health-care professionals, have an important role but appear reluctant to address these concerns because of fears of insufficient time and expertise.

  14. Recommendations for newborn screening for galactokinase deficiency: A systematic review and evaluation of Dutch newborn screening data.

    Science.gov (United States)

    Stroek, Kevin; Bouva, Marelle J; Schielen, Peter C J I; Vaz, Frédéric M; Heijboer, Annemieke C; de Jonge, Robert; Boelen, Anita; Bosch, Annet M

    2018-03-21

    Galactokinase (GALK) deficiency causes cataract leading to severe developmental consequences unless treated early. Because of the easy prevention and rapid reversibility of cataract with treatment, the Dutch Health Council advised to include GALK deficiency in the Dutch newborn screening program. The aim of this study is to establish the optimal screening method and cut-off value (COV) for GALK deficiency screening by performing a systematic review of the literature of screening strategies and total galactose (TGAL) values and by evaluating TGAL values in the first week of life in a cohort of screened newborns in the Netherlands. Systematic literature search strategies in OVID MEDLINE and OVID EMBASE were developed and study selection, data collection and analyses were performed by two independent investigators. A range of TGAL values measured by the Quantase Neonatal Total Galactose screening assay in a cohort of Dutch newborns in 2007 was evaluated. Eight publications were included in the systematic review. All four studies describing screening strategies used TGAL as the primary screening marker combined with galactose-1-phosphate uridyltransferase (GALT) measurement that is used for classical galactosemia screening. TGAL COVs of 2200 μmol/L, 1665 μmol/L and 1110 μmol/L blood resulted in positive predictive values (PPV) of 100%, 82% and 10% respectively. TGAL values measured in the newborn period were reported for 39 GALK deficiency patients with individual values ranging from 3963 to 8159 μmol/L blood and 2 group values with mean 8892 μmol/L blood (SD ± 5243) and 4856 μmol/L blood (SD ± 461). Dutch newborn screening data of 72,786 newborns from 2007 provided a median TGAL value of 110 μmol/L blood with a range of 30-2431 μmol/L blood. Based on TGAL values measured in GALK deficiency patients reported in the literature and TGAL measurements in the Dutch cohort by newborn screening we suggest to perform the GALK screening with

  15. Evaluation of a dysphagia screening system based on the Mann Assessment of Swallowing Ability for use in dependent older adults.

    Science.gov (United States)

    Ohira, Mariko; Ishida, Ryo; Maki, Yoshinobu; Ohkubo, Mai; Sugiyama, Tetsuya; Sakayori, Takaharu; Sato, Toru

    2017-04-01

    Dysphagia is common in dependent older adults. Thus, a method of evaluating eating and swallowing functions that can be used to diagnose and manage dysphagia in a simple and robust manner is required. In 2002, the Mann Assessment of Swallowing Ability (MASA) was introduced to identify dysphagia in acute-stage stroke patients. As the MASA enables easy screening, it might also be applicable to dependent older adults if appropriate MASA cut-off values and the most useful assessment items could be determined. In the present study, we attempted to determine suitable MASA cut-off values, and the most useful assessment items for predicting aspiration and pharyngeal retention in dependent older adults. Using the MASA, we evaluated the eating and swallowing functions of 50 dependent older adults with dysphagia. All of the patients also underwent videoendoscopic-based swallowing evaluations to detect aspiration and pharyngeal retention. The participants' characteristics and the utility of each assessment item were compared between various groups. Using the patients' videoendoscopic findings as a reference, receiver operating characteristic curve analysis was carried out to determine appropriate cut-off values for predicting aspiration and pharyngeal retention in dependent older adults. The optimal MASA cut-off values for predicting aspiration and pharyngeal retention were 122 points and 151 points, respectively. A total of 17 of the 24 clinical items assessed by the MASA were found to be associated with aspiration in dependent older adults. The MASA is a useful screening tool for evaluating eating and swallowing functions in dependent older adults. Geriatr Gerontol Int 2017; 17: 561-567. © 2016 Japan Geriatrics Society.

  16. A systematic approach to evaluate erosion potential at environmental restoration sites

    International Nuclear Information System (INIS)

    Veenis, S.J.; Mays, D.C.

    1998-01-01

    The Environmental Restoration (ER) Project at the Los Alamos National Laboratory (LANL) is responsible for investigation and remediation of solid waste management units (SWMUs) under the Resource Conservation and Recovery Act and area of concerns (AOCs) under the direction of the Department of Energy. During the investigation and remediation phases, information may be gathered that indicates that conditions may be present at the site which may effect surface water quality. Depending on the constituent found, its concentration, and erosion/sediment transport potential, it may be necessary to implement temporary or permanent mitigative measures

  17. R-IDEAL : A Framework for Systematic Clinical Evaluation of Technical Innovations in Radiation Oncology

    NARCIS (Netherlands)

    Verkooijen, Helena M; Kerkmeijer, LGW; Fuller, Clifton D; Huddart, Robbert; Faivre-Finn, Corinne; Verheij, Marcel; Mook, Stella; Sahgal, Arjun; Hall, Emma; Schultz, Chris

    2017-01-01

    The pace of innovation in radiation oncology is high and the window of opportunity for evaluation narrow. Financial incentives, industry pressure, and patients' demand for high-tech treatments have led to widespread implementation of innovations before, or even without, robust evidence of improved

  18. A Systematic Review and Psychometric Evaluation of Adaptive Behavior Scales and Recommendations for Practice

    Science.gov (United States)

    Floyd, Randy G.; Shands, Elizabeth I.; Alfonso, Vincent C.; Phillips, Jessica F.; Autry, Beth K.; Mosteller, Jessica A.; Skinner, Mary; Irby, Sarah

    2015-01-01

    Adaptive behavior scales are vital in assessing children and adolescents who experience a range of disabling conditions in school settings. This article presents the results of an evaluation of the design characteristics, norming, scale characteristics, reliability and validity evidence, and bias identification studies supporting 14…

  19. Low health literacy and evaluation of online health information: A systematic review of the literature

    NARCIS (Netherlands)

    Diviani, N.; van den Putte, B.; Giani, S.; van Weert, J.C.M.

    2015-01-01

    Background: Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to

  20. Systematization of the Methods for Evaluating the International Competitiveness of Enterprise

    Directory of Open Access Journals (Sweden)

    Shtal Tetyana V.

    2016-01-01

    Full Text Available The article is aimed at studying methods for evaluating competitiveness, identifying their practical relevance to domestic enterprises on example of the ОАО «Zavod «Yuzhkabel». A system of methods for evaluating international competitiveness of enterprises has been analyzed, the most frequently encountered in the economic literature methodologies for estimation have been considered. As a result, weaknesses of the individual elements of the system have been identified. Practical significance of the study has been disclosed, the most effective methods for evaluating the international competitiveness of enterprises have been identified. Using methods such as the method of rating estimation, the «4Р» matrix, the «McKinsey» matrix, the HirfindahlHirschman index and the polygon of competitiveness model, international competitiveness of the ОАО «Zavod «Yuzhkabel» has been evaluated. Conclusion about the extent of enterprise's presence at the international market has been made.

  1. Instruments for the assessment of suicide risk: A systematic review evaluating the certainty of the evidence.

    Directory of Open Access Journals (Sweden)

    Bo Runeson

    Full Text Available Instruments have been developed to facilitate suicide risk assessment. We aimed to evaluate the evidence for these instruments including assessment of risk of bias and diagnostic accuracy for suicide and suicide attempt.PubMed (NLM, PsycInfo, Embase, Cinahl and the Cochrane Library databases were searched until December 2014. We assessed risk of bias with QUADAS-2. The average sensitivity and specificity of each instrument was estimated and the certainty of the evidence was assessed with GRADE. We considered instruments with a sensitivity > 80% and a specificity > 50% to have sufficient diagnostic accuracy.Thirty-five relevant studies were identified but 14 were considered to have high risk of bias, leaving 21 studies evaluating altogether 15 risk assessment instruments. We could carry out meta-analyses for five instruments. For the outcome suicide attempt SAD PERSONS Scale had a sensitivity of 15% (95% CI 8-24 and specificity of 97% (96-98, and the Manchester Self-Harm Rule (MSHR a sensitivity of 97% (97-97 and a specificity of 20% (20-21. ReACT, which is a modification of MSHR, had a similar low specificity, as did the Sodersjukhuset Self Harm Rule. For the outcome suicide, the Beck Hopelessness Scale had a sensitivity of 89% (78-95 and specificity of 42% (40-43.Most suicide risk assessment instruments were supported by too few studies to allow for evaluation of accuracy. Among those that could be evaluated, none fulfilled requirements for sufficient diagnostic accuracy.

  2. Towards systematic evaluation of crop model outputs for global land-use models

    Science.gov (United States)

    Leclere, David; Azevedo, Ligia B.; Skalský, Rastislav; Balkovič, Juraj; Havlík, Petr

    2016-04-01

    Land provides vital socioeconomic resources to the society, however at the cost of large environmental degradations. Global integrated models combining high resolution global gridded crop models (GGCMs) and global economic models (GEMs) are increasingly being used to inform sustainable solution for agricultural land-use. However, little effort has yet been done to evaluate and compare the accuracy of GGCM outputs. In addition, GGCM datasets require a large amount of parameters whose values and their variability across space are weakly constrained: increasing the accuracy of such dataset has a very high computing cost. Innovative evaluation methods are required both to ground credibility to the global integrated models, and to allow efficient parameter specification of GGCMs. We propose an evaluation strategy for GGCM datasets in the perspective of use in GEMs, illustrated with preliminary results from a novel dataset (the Hypercube) generated by the EPIC GGCM and used in the GLOBIOM land use GEM to inform on present-day crop yield, water and nutrient input needs for 16 crops x 15 management intensities, at a spatial resolution of 5 arc-minutes. We adopt the following principle: evaluation should provide a transparent diagnosis of model adequacy for its intended use. We briefly describe how the Hypercube data is generated and how it articulates with GLOBIOM in order to transparently identify the performances to be evaluated, as well as the main assumptions and data processing involved. Expected performances include adequately representing the sub-national heterogeneity in crop yield and input needs: i) in space, ii) across crop species, and iii) across management intensities. We will present and discuss measures of these expected performances and weight the relative contribution of crop model, input data and data processing steps in performances. We will also compare obtained yield gaps and main yield-limiting factors against the M3 dataset. Next steps include

  3. Technical Note: Evaluation of the systematic accuracy of a frameless, multiple image modality guided, linear accelerator based stereotactic radiosurgery system

    Energy Technology Data Exchange (ETDEWEB)

    Wen, N., E-mail: nwen1@hfhs.org; Snyder, K. C.; Qin, Y.; Li, H.; Siddiqui, M. S.; Chetty, I. J. [Department of Radiation Oncology, Henry Ford Health System, 2799 West Brand Boulevard, Detroit, Michigan 48202 (United States); Scheib, S. G.; Schmelzer, P. [Varian Medical System, Täfernstrasse 7, Dättwil AG 5405 (Switzerland)

    2016-05-15

    Purpose: To evaluate the total systematic accuracy of a frameless, image guided stereotactic radiosurgery system. Methods: The localization accuracy and intermodality difference was determined by delivering radiation to an end-to-end prototype phantom, in which the targets were localized using optical surface monitoring system (OSMS), electromagnetic beacon-based tracking (Calypso®), cone-beam CT, “snap-shot” planar x-ray imaging, and a robotic couch. Six IMRT plans with jaw tracking and a flattening filter free beam were used to study the dosimetric accuracy for intracranial and spinal stereotactic radiosurgery treatment. Results: End-to-end localization accuracy of the system evaluated with the end-to-end phantom was 0.5 ± 0.2 mm with a maximum deviation of 0.9 mm over 90 measurements (including jaw, MLC, and cone measurements for both auto and manual fusion) for single isocenter, single target treatment, 0.6 ± 0.4 mm for multitarget treatment with shared isocenter. Residual setup errors were within 0.1 mm for OSMS, and 0.3 mm for Calypso. Dosimetric evaluation based on absolute film dosimetry showed greater than 90% pass rate for all cases using a gamma criteria of 3%/1 mm. Conclusions: The authors’ experience demonstrates that the localization accuracy of the frameless image-guided system is comparable to robotic or invasive frame based radiosurgery systems.

  4. Intergrated plant safety assessment. Systematic evaluation program. Palisades plant, Consumers Power Company, Docket No. 50-255. Final report

    International Nuclear Information System (INIS)

    1982-10-01

    The Nuclear Regulatory Commission (NRC) has published its Final Integrated Plant Safety Assessment Report (IPSAR) (NUREG-0820), under the scope of the Systematic Evaluation Program (SEP), for Consumers Power Company's Palisades Plant located in Covert, Van Buren County, Michigan. The SEP was initiated by the NRC to review the design of older operating nuclear reactor plants to reconfirm and document their safety. This report documents the review completed under the SEP for the Palisades Plant. The review has provided for (1) as assessment of the significance of differences between current technical positions on selected safety issues and those that existed when the Palisades Plant was licensed, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety when all supplements to the Final IPSAR and the Safety Evaluation Report for converting the license from a provisional to a full-term license have been issued. The report also addresses the comments and recommendations made by the Advisory Committee on Reactor Safeguards in connection with its review of the Draft Report, issued in April 1982

  5. Drugs and herbs given to prevent hepatotoxicity of tuberculosis therapy: systematic review of ingredients and evaluation studies

    Directory of Open Access Journals (Sweden)

    Huang Binghua

    2008-10-01

    Full Text Available Abstract Background Drugs to protect the liver are frequently prescribed in some countries as part of treatment for tuberculosis. The biological rationale is not clear, they are expensive and may do harm. We conducted a systematic review to a describe the ingredients of "liver protection drugs"; and b compare the evidence base for the policy against international standards. Methods We searched international medical databases (MEDLINE, EMBASE, LILACS, CINAHL, Cochrane Central Register of Controlled Trials, and the specialised register of the Cochrane Infectious Diseases Group and Chinese language databases (CNKI, VIP and WanFang to April 2007. Our inclusion criteria were research papers that reported evaluating any liver protection drug or drugs for preventing liver damage in people taking anti-tuberculosis treatment. Two authors independently categorised and extracted data, and appraised the stated methods of evaluating their effectiveness. Results Eighty five research articles met our inclusion criteria, carried out in China (77, India (2, Russia (4, Ukraine (2. These articles evaluated 30 distinct types of liver protection compounds categorised as herbal preparations, manufactured herbal products, combinations of vitamins and other non-herbal substances and manufactured pharmaceutical preparations. Critical appraisal of these articles showed that all were small, poorly conducted studies, measuring intermediate outcomes. Four trials that were described as randomised controlled trials were small, had short follow up, and did not meet international standards. Conclusion There is no reliable evidence to support prescription of drugs or herbs to prevent liver damage in people on tuberculosis treatment.

  6. Technical Note: Evaluation of the systematic accuracy of a frameless, multiple image modality guided, linear accelerator based stereotactic radiosurgery system

    International Nuclear Information System (INIS)

    Wen, N.; Snyder, K. C.; Qin, Y.; Li, H.; Siddiqui, M. S.; Chetty, I. J.; Scheib, S. G.; Schmelzer, P.

    2016-01-01

    Purpose: To evaluate the total systematic accuracy of a frameless, image guided stereotactic radiosurgery system. Methods: The localization accuracy and intermodality difference was determined by delivering radiation to an end-to-end prototype phantom, in which the targets were localized using optical surface monitoring system (OSMS), electromagnetic beacon-based tracking (Calypso®), cone-beam CT, “snap-shot” planar x-ray imaging, and a robotic couch. Six IMRT plans with jaw tracking and a flattening filter free beam were used to study the dosimetric accuracy for intracranial and spinal stereotactic radiosurgery treatment. Results: End-to-end localization accuracy of the system evaluated with the end-to-end phantom was 0.5 ± 0.2 mm with a maximum deviation of 0.9 mm over 90 measurements (including jaw, MLC, and cone measurements for both auto and manual fusion) for single isocenter, single target treatment, 0.6 ± 0.4 mm for multitarget treatment with shared isocenter. Residual setup errors were within 0.1 mm for OSMS, and 0.3 mm for Calypso. Dosimetric evaluation based on absolute film dosimetry showed greater than 90% pass rate for all cases using a gamma criteria of 3%/1 mm. Conclusions: The authors’ experience demonstrates that the localization accuracy of the frameless image-guided system is comparable to robotic or invasive frame based radiosurgery systems.

  7. Effectiveness of Online Cancer Education for Nurses and Allied Health Professionals; a Systematic Review Using Kirkpatrick Evaluation Framework.

    Science.gov (United States)

    Campbell, Karen; Taylor, Vanessa; Douglas, Sheila

    2017-12-12

    Embedding online learning within higher education can provide engaging, cost-effective, interactive and flexible education. By evaluating the impact, outcomes and pedagogical influence of online cancer and education, future curricula can be shaped and delivered by higher education providers to better meet learner, health care provider and educational commissioners' requirements for enhanced patient care and service delivery needs. Using the Kirkpatrick's four-level model of educational evaluation, a systematic review of the effectiveness of online cancer education for nurses and allied health professionals was conducted. From 101 articles, 30 papers were included in the review. Educational theory is not always employed. There is an absence of longitudinal studies to examine impact; an absence of reliability and/or validity testing of measures, limited experimental designs taking account of power and few attempts to mitigate bias. There is, however, an emerging innovative use of mobile/spaced learning techniques. Evidence for clinical and educational effectiveness is weak offering insights into experiences and participant perceptions rather than concrete quantitative data and patient-reported outcomes. More pedagogical research is merited to inform effective evaluation of online cancer education, which incorporates and demonstrates a longer-term impact.

  8. Modeling companion diagnostics in economic evaluations of targeted oncology therapies: systematic review and methodological checklist.

    Science.gov (United States)

    Doble, Brett; Tan, Marcus; Harris, Anthony; Lorgelly, Paula

    2015-02-01

    The successful use of a targeted therapy is intrinsically linked to the ability of a companion diagnostic to correctly identify patients most likely to benefit from treatment. The aim of this study was to review the characteristics of companion diagnostics that are of importance for inclusion in an economic evaluation. Approaches for including these characteristics in model-based economic evaluations are compared with the intent to describe best practice methods. Five databases and government agency websites were searched to identify model-based economic evaluations comparing a companion diagnostic and subsequent treatment strategy to another alternative treatment strategy with model parameters for the sensitivity and specificity of the companion diagnostic (primary synthesis). Economic evaluations that limited model parameters for the companion diagnostic to only its cost were also identified (secondary synthesis). Quality was assessed using the Quality of Health Economic Studies instrument. 30 studies were included in the review (primary synthesis n = 12; secondary synthesis n = 18). Incremental cost-effectiveness ratios may be lower when the only parameter for the companion diagnostic included in a model is the cost of testing. Incorporating the test's accuracy in addition to its cost may be a more appropriate methodological approach. Altering the prevalence of the genetic biomarker, specific population tested, type of test, test accuracy and timing/sequence of multiple tests can all impact overall model results. The impact of altering a test's threshold for positivity is unknown as it was not addressed in any of the included studies. Additional quality criteria as outlined in our methodological checklist should be considered due to the shortcomings of standard quality assessment tools in differentiating studies that incorporate important test-related characteristics and those that do not. There is a need to refine methods for incorporating the characteristics

  9. Using theory of change to design and evaluate public health interventions: a systematic review.

    Science.gov (United States)

    Breuer, Erica; Lee, Lucy; De Silva, Mary; Lund, Crick

    2016-05-06

    Despite the increasing popularity of the theory of change (ToC) approach, little is known about the extent to which ToC has been used in the design and evaluation of public health interventions. This review aims to determine how ToCs have been developed and used in the development and evaluation of public health interventions globally. We searched for papers reporting the use of "theory of change" in the development or evaluation of public health interventions in databases of peer-reviewed journal articles such as Scopus, Pubmed, PsychInfo, grey literature databases, Google and websites of development funders. We included papers of any date, language or study design. Both abstracts and full text papers were double screened. Data were extracted and narratively and quantitatively summarised. A total of 62 papers were included in the review. Forty-nine (79 %) described the development of ToC, 18 (29 %) described the use of ToC in the development of the intervention and 49 (79 %) described the use of ToC in the evaluation of the intervention. Although a large number of papers were included in the review, their descriptions of the ToC development and use in intervention design and evaluation lacked detail. The use of the ToC approach is widespread in the public health literature. Clear reporting of the ToC process and outputs is important to strengthen the body of literature on practical application of ToC in order to develop our understanding of the benefits and advantages of using ToC. We also propose a checklist for reporting on the use of ToC to ensure transparent reporting and recommend that our checklist is used and refined by authors reporting the ToC approach.

  10. Dependent lung opacity at thin-section CT: evaluation by spirometrically-gated CT of the influence of lung volume

    International Nuclear Information System (INIS)

    Lee, Ki Nam; Yoon, Seong Kuk; Sohn, Choon Hee; Choi, Pil Jo; Webb, W. Richard

    2002-01-01

    To evaluate the influence of lung volume on dependent lung opacity seen at thin-section CT. In thirteen healthy volunteers, thin-section CT scans were performed at three levels (upper, mid, and lower portion of the lung) and at different lung volumes (10, 30, 50, and 100% vital capacity), using spirometric gated CT. Using a three-point scale, two radiologists determined whether dependent opacity was present, and estimated its degree. Regional lung attenuation at a level 2 cm above the diaphragm was determined using semiautomatic segmentation, and the diameter of a branch of the right lower posterior basal segmental artery was measured at each different vital capacity. At all three anatomic levels, dependent opacity occurred significantly more often at lower vital capacities (10, 30%) than at 100% vital capacity (p = 0.001). Visually estimated dependent opacity was significantly related to regional lung attenuation (p < 0.0001), which in dependent areas progressively increased as vital capacity decreased (p < 0.0001). The presence of dependent opacity and regional lung attenuation of a dependent area correlated significantly with increased diameter of a segmental arterial branch (r = 0.493 and p = 0.0002; r = 0.486 and p 0.0003, respectively). Visual estimation and CT measurements of dependent opacity obtained by semiautomatic segmentation are significantly influenced by lung volume and are related to vascular diameter

  11. Meniscus matrix morphological composition: age-dependent evaluation in a swine model

    Directory of Open Access Journals (Sweden)

    Umberto Polito

    2017-06-01

    Full Text Available Menisci are fibro-cartilaginous structures interposed between femoral condyle and tibial plateau, which have multiple functions in the stifle joint: act as shock absorbers, bear loaders and allow joint stability, congruity and lubrication (Sweigart et al., 2004; Proffen et al., 2012. It is well known that meniscal injuries lead to osteoarthritis and for these reasons, menisci are considered important target of investigation. Their important role in the knee wellness is only equalled by their deficiency in proper self-repairing. Nowadays, the gold standard technique is not just to remove the damaged meniscus, but to rebuild it or to replace it. For these reasons, studies are necessary to increase the knowledge about these small but essential structures (Streuli, 1999; Deponti et al., 2013. Composition and morphology are basic fundamental information for the development of engineered meniscal substitutes (Di Giancamillo et al., 2014. The analysis of the morphological, structural and biochemical changes, which occur during growth of the normal menisci, represent the goal of the present study. For this purpose, menisci from adult (7-month old, young (1-month old, and neonates (stillbirths pigs were collected. Cellularity and glycosamiglycans (GAGs deposition were evaluated by ELISA, while Collagen-1 and Collagen-2 were investigated by immunohistochemistry and Western blot analyses. Cellularity (P<0.01, all comparisons and Collagen-1 (P<0.05, neonatal-young vs adult decreased from neonatal to adult stage while GAGs (P<0.01 neonatal vs young-adult and Collagen-2 (P<0.01 neonatal-young vs adult showed the opposite trend. Immunohistochemistry revealed similar changes occurring during animal growth thus revealing that cellular phenotype, cellularity and protein expression, as well as fibers aggregation in the matrix, are dissimilar in the three ages analysed categories. These changes reflect the progressive menisci maturation and hyper-specialisation. We

  12. ERESYE - a expert system for the evaluation of uncertainties related to systematic experimental errors; ERESYE - un sistema esperto per la valutazione di incertezze correlate ad errori sperimentali sistematici

    Energy Technology Data Exchange (ETDEWEB)

    Martinelli, T; Panini, G C [ENEA - Dipartimento Tecnologie Intersettoriali di Base, Centro Ricerche Energia, Casaccia (Italy); Amoroso, A [Ricercatore Ospite (Italy)

    1989-11-15

    Information about systematic errors are not given In EXFOR, the data base of nuclear experimental measurements: their assessment is committed to the ability of the evaluator. A tool Is needed which performs this task in a fully automatic way or, at least, gives a valuable aid. The expert system ERESYE has been implemented for investigating the feasibility of an automatic evaluation of the systematic errors in the experiments. The features of the project which led to the implementation of the system are presented. (author)

  13. Evaluation of the quality of the reporting of phase II clinical trials in oncology: A systematic review.

    Science.gov (United States)

    Rivoirard, Romain; Langrand-Escure, Julien; Oriol, Mathieu; Tinquaut, Fabien; Chauvin, Franck; Rancoule, Chloé; Magné, Nicolas; Bourmaud, Aurélie

    2018-05-01

    To describe the current state of knowledge concerning the quality of reporting in phase II clinical trials in oncology and to describe the various methods published allowing this quality evaluation. databases including MEDLINE and COCHRANE were searched. Reviews and meta-analyses analyzing the quality of the reporting of phase II trials in oncology were included. Descriptive analysis of the results was performed. Thirteen publications were retained. Only 2 publications adopted a systematic approach of evaluation of the quality of reporting by overall scores. The Key Methodological Score (KMS), proposed by Grellety et al., gathering 3 items, seemed adapted for such an evaluation. A score of 3/3 was found in 16.1% of the 156 phase II trials analysed by this score. The other reviews used a qualitative analysis to evaluate the reporting, via an analysis of a single criterion, generally the statistical plan of the study. This item was considered as having been correctly reported in less than 50% of the analysed articles. The quality of reporting in phase II trials in oncology is a field that has been investigated very little (13 publications). When it is studied, the estimated level of quality is not satisfactory, whatever the method employed. The use of an overall score of evaluation is a path which should be pursued, in order to get reliable results. It also seems necessary to propose strong recommendations, which would create a consensus for the methodology and the reporting of these studies. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Establishing consensus on the definition of an isolated hip fracture for trauma system performance evaluation: A systematic review

    Directory of Open Access Journals (Sweden)

    Judith Tiao

    2014-01-01

    Full Text Available Background: Risk-adjusted mortality is widely used to benchmark trauma center care. Patients presenting with isolated hip fractures (IHFs are usually excluded from these evaluations. However, there is no standardized definition of an IHF. We aimed to evaluate whether there is consensus on the definition of an IHF used as an exclusion criterion in studies evaluating the performance of trauma centers in terms of mortality. Materials and Methods: We conducted a systematic review of observational studies. We searched the electronic databases MEDLINE, EMBASE, BIOSIS, The Cochrane Library, CINAHL, TRIP Database, and PROQUEST for cohort studies that presented data on mortality to assess the performance of trauma centers and excluded IHF. A standardized, piloted data abstraction form was used to extract data on study settings, IHF definitions and methodological quality of included studies. Consensus was considered to be reached if more than 50% of studies used the same definition of IHF. Results: We identified 8,506 studies of which 11 were eligible for inclusion. Only two studies (18% used the same definition of an IHF. Three (27% used a definition based on Abbreviated Injury Scale (AIS Codes and five (45% on International Classification of Diseases (ICD codes. Four (36% studies had inclusion criteria based on age, five (45% on secondary injuries, and four (36% on the mechanism of injury. Eight studies (73% had good overall methodological quality. Conclusions: We observed important heterogeneity in the definition of an IHF used as an exclusion criterion in studies evaluating the performance of trauma centers. Consensus on a standardized definition is needed to improve the validity of evaluations of the quality of trauma care.

  15. Vitamin K to prevent fractures in older women: systematic review and economic evaluation.

    Science.gov (United States)

    Stevenson, M; Lloyd-Jones, M; Papaioannou, D

    2009-09-01

    To determine the clinical and cost-effectiveness of vitamin K in preventing osteoporotic fractures in postmenopausal women. Searches were conducted in May 2007 in MEDLINE, MEDLINE In-Process, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, BIOSIS, CINAHL, DARE, NHS EED and HTA databases, AMED, NRR, Science Citation Index and Current Controlled Trials. The MEDLINE search was updated in March 2009. Selected studies were assessed and subjected to data extraction and quality assessment using standard methods. Where appropriate, meta-analysis was carried out. A mathematical model was constructed to estimate the cost-effectiveness of vitamin K1. The electronic literature searches identified 1078 potentially relevant articles. Of these, 14 articles relating to five trials that compared vitamin K with a relevant comparator in postmenopausal women with osteoporosis or osteopenia met the review inclusion criteria. The double-blind ECKO trial compared 5 mg of phylloquinone (vitamin K1) with placebo in Canadian women with osteopenia but without osteoporosis. Four open-label trials used 45 mg of menatetrenone (vitamin K2) in Japanese women with osteoporosis; the comparators were no treatment, etidronate or calcium. The methodological quality of the ECKO trial was good; however, all four menatetrenone trials were poorly reported and three were very small (n vitamin K were found and a mathematical model was thus constructed to estimate the cost-effectiveness of vitamin K1. Comparators were alendronate, risedronate and strontium ranelate. Vitamin K1 and alendronate were markedly more cost-effective than either risedronate or strontium ranelate. The base-case results favoured vitamin K1, but this relied on many assumptions, particularly on the efficacy of preventing hip and vertebral fractures. Calculation of the expected value of sampled information was conducted assuming a randomised controlled trial of 5 years' duration comparing alendronate

  16. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans

    2014-01-01

    %) to "poor" (43%), with only one study rated as "good". The reliability domain was most often investigated. Few of the assessment methods in the included studies that had "fair" or "good" measurement property ratings demonstrated acceptable results for both reliability and validity. We found a substantially...... larger number of clinical scapular assessment methods than previously reported. Using the COSMIN checklist the methodological quality of the included measurement properties in the reliability and validity domains were in general "fair" to "poor". None were examined for all three domains: (1) reliability...... excluded for evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was "fair" (57...

  17. Human-Computer Interfaces for Wearable Computers: A Systematic Approach to Development and Evaluation

    OpenAIRE

    Witt, Hendrik

    2007-01-01

    The research presented in this thesis examines user interfaces for wearable computers.Wearable computers are a special kind of mobile computers that can be worn on the body. Furthermore, they integrate themselves even more seamlessly into different activities than a mobile phone or a personal digital assistant can.The thesis investigates the development and evaluation of user interfaces for wearable computers. In particular, it presents fundamental research results as well as supporting softw...

  18. A systematic review and economic evaluation of bisphosphonates for the prevention of fragility fractures.

    OpenAIRE

    Davis, S.; Martyn-St James, M.; Sanderson, J.; Stevens, J.; Goka, E.; Rawdin, A.; Sadler, S.; Wong, R.; Campbell, F.; Stevenson, M.; Strong, M.; Selby, P.; Gittoes, N.

    2016-01-01

    BACKGROUND: Fragility fractures are fractures that result from mechanical forces that would not ordinarily result in fracture. OBJECTIVES: To evaluate the clinical effectiveness and safety of bisphosphonates [alendronic acid (Fosamax(®) and Fosamax(®) Once Weekly, Merck Sharp & Dohme Ltd), risedronic acid (Actonel(®) and Actonel Once a Week(®), Warner Chilcott UK Ltd), ibandronic acid (Bonviva(®), Roche Products Ltd) and zoledronic acid (Aclasta(®), Novartis Pharmaceuticals UK Ltd)] for the p...

  19. What is the quality of economic evaluations of non-drug therapies? A systematic review and critical appraisal of economic evaluations of radiotherapy for cancer.

    Science.gov (United States)

    Barbieri, M; Weatherly, H L A; Ara, R; Basarir, H; Sculpher, M; Adams, R; Ahmed, H; Coles, C; Guerrero-Urbano, T; Nutting, C; Powell, M

    2014-10-01

    Breast, cervical and colorectal cancers are the three most frequent cancers in women, while lung, prostate and colorectal cancers are the most frequent in men. Much attention has been given to the economic evaluation of pharmaceuticals for treatment of cancer by the National Institute for Health and Care Excellence (NICE) in the UK and similar authorities internationally, while economic analysis developed for other types of anti-cancer interventions, including radiotherapy and surgery, are less common. Our objective was to review methods used in published cost-effectiveness studies evaluating radiotherapy for breast, cervical, colorectal, head and neck and prostate cancer, and to compare the economic evaluation methods applied with those defined in the guidelines used by the NICE technology appraisal programme. A systematic search of seven databases (MEDLINE, EMBASE, CDSR, NHSEED, HTA, DARE, EconLit) as well as research registers, the NICE website and conference proceedings was conducted in July 2012. Only economic evaluations of radiotherapy interventions in individuals diagnosed with cancer that included quality-adjusted life-years (QALYs) or life-years (LYs) were included. Included studies were appraised on the basis of satisfying essential, preferred and UK-specific methods requirements, building on the NICE Reference Case for economic evaluations and on other methods guidelines. A total of 29 studies satisfied the inclusion criteria (breast 14, colorectal 2, prostate 10, cervical 0, head and neck 3). Only two studies were conducted in the UK (13 in the USA). Among essential methods criteria, the main issue was that only three (10%) of the studies used clinical-effectiveness estimates identified through systematic review of the literature. Similarly, only eight (28%) studies sourced health-related quality-of-life data directly from patients with the condition of interest. Other essential criteria (e.g. clear description of comparators, patient group indication

  20. Evaluation of Fatigue Behavior in Dental Implants from In Vitro Clinical Tests: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Rosa Rojo

    2018-05-01

    Full Text Available In the area of dentistry, there is a wide variety of designs of dental implant and materials, especially titanium, which aims to avoid failures and increase their clinical durability. The purpose of this review was to evaluate fatigue behavior in different connections and implant materials, as well as their loading conditions and response to failure. In vitro tests under normal and dynamic loading conditions evaluating fatigue at implant and abutment connection were included. A search was conducted in PubMed, Scopus, and Science Direct. Data extraction was performed independently by two reviewers. The quality of selected studies was assessed using the Cochrane Handbook proposed by the tool for clinical trials. Nineteen studies were included. Fourteen studies had an unclear risk and five had high risk of bias. Due to the heterogeneity of the data and the evaluation of the quality of the studies, meta-analysis could not be performed. Evidence from this study suggests that both internal and morse taper connections presented a better behavior to failure. However, it is necessary to unify criteria in the methodological design of in vitro studies, following methodological guidelines and establishing conditions that allow the homogenization of designs in ISO (International Organization for Standardization standards.

  1. Reminiscence therapy using odor in alcohol-dependent patients--psychophysiological evaluation and psychological evaluation; power spectral analysis of heart rate variability.

    Science.gov (United States)

    Arizono, H; Morita, N; Iizuka, S; Satoh, S; Nakatani, Y

    2000-12-01

    This research was based on the hypothesis that when alcohol-dependent patients describe themselves, awakening of emotion by affirmative odor stimulation may facilitate memory reframing focusing on more affirmative emotion and memories. To prove the hypothesis, physiological changes accompanied by emotional awakening were evaluated by measuring the autonomic activity. In addition, subjective evaluation by a self-report manner was examined to investigate the effectiveness of Reminiscence Therapy (RT) using odor in alcohol-dependent patients. Thirty-four patients who met the DSM-IV criteria of alcohol-related disorders and were hospitalized in a ward specialized to alcohol dependence therapy. Each patient underwent a one-to-one interview twice. For counterbalance, one interview was performed with odor stimulation using an odor with a relaxing effect that recall pleasant emotion, and the other was without odor stimulation. As the evaluation indices of physiological changes accompanied by emotional awakening, index of autonomic function (HRV; Heart rate variability) for objective evaluation and psychological indices (STAI; State-Trait Anxiety Inventory VAS; Visual Analog Scale) for subjective evaluation were measured. 1) Objective evaluation: Regarding the evaluation index of the autonomic function, the sympathetic nervous system activity (LF/HF; low frequency component/high frequency component ratio) was significantly inhibited by odor stimulation (p Subjective evaluation: Compared to the state prior to interview, state anxiety judged by STAI was significantly decreased after interview (p subjective evaluation, but the objective evaluation suggested that the odor inhibited the sympathetic nervous system. Thus, it was suggested that odor can be used in RT, that is, emotional changes due to stimulation of odor may be applicable in RT.

  2. How Teachers Evaluate Their Work Style Depending on the Subject They Teach and Years of Work Experience

    Science.gov (United States)

    Perucica, Ranka

    2017-01-01

    In previous works we presented the studies that discussed how students evaluate their teachers and their style of teaching. To what extent their styles affect the students' attitudes to teaching, learning, success, motivation and the like. In this work we have tried to point out how teachers assess their style of work, depending on the subject…

  3. Economic evaluations of interventions to manage hyperphosphataemia in adult haemodialysis patients: A systematic review.

    Science.gov (United States)

    Rizk, Rana; Hiligsmann, Mickaël; Karavetian, Mirey; Evers, Silvia Maa

    2016-03-01

    Managing hyperphosphataemia in haemodialysis patients is resource-intensive. A search for cost-effective interventions in this field is needed to inform decisions on the allocation of healthcare resources. NHSEED, MEDLINE, EMBASE and CINAHL were searched for full economic evaluations of hyperphosphataemia-managing interventions in adult haemodialysis patients, published between 2004 and 2014, in English, French, Dutch or German. Incremental cost-effectiveness ratios of the interventions were up-rated to 2013US$ using Purchasing Power Parity conversion rates and Consumer Price Indices. The quality of included studies was assessed using the Extended Consensus on Health Economic Criteria List. Twelve out of the 1681 retrieved records fulfilled the inclusion criteria. They reported only on one aspect of hyperphosphataemia management, which is the use of phosphate binders (calcium-based and calcium-free, in first-line and sequential use). No economic evaluations of other phosphorus-lowering interventions were found. The included articles derived from five countries and most of them were funded by pharmaceutical companies. The incremental cost-effectiveness ratios of phosphate binders ranged between US$11 461 and US$157 760 per quality-adjusted life-year gained. Calcium-based binders (especially calcium acetate) appear to be the optimal cost-effective first- and second-line therapy in prevalent patients, while the calcium-free binder, lanthanum carbonate, might provide good value for money, as second-line therapy, in incident patients. The studies' overall quality was suboptimal. Drawing firm conclusions was not possible due to the quality heterogeneity and inconsistent results. Future high-quality economic evaluations are needed to confirm the findings of this review and to address other interventions to manage hyperphosphataemia in this population. © 2015 Asian Pacific Society of Nephrology.

  4. Spinal cord stimulation for chronic pain of neuropathic or ischaemic origin: systematic review and economic evaluation.

    Science.gov (United States)

    Simpson, E L; Duenas, A; Holmes, M W; Papaioannou, D; Chilcott, J

    2009-03-01

    This report addressed the question 'What is the clinical and cost-effectiveness of spinal cord stimulation (SCS) in the management of chronic neuropathic or ischaemic pain?' Thirteen electronic databases [including MEDLINE (1950-2007), EMBASE (1980-2007) and the Cochrane Library (1991-2007)] were searched from inception; relevant journals were hand-searched; and appropriate websites for specific conditions causing chronic neuropathic/ischaemic pain were browsed. Literature searches were conducted from August 2007 to September 2007. A systematic review of the literature sought clinical and cost-effectiveness data for SCS in adults with chronic neuropathic or ischaemic pain with inadequate response to medical or surgical treatment other than SCS. Economic analyses were performed to model the cost-effectiveness and cost-utility of SCS in patients with neuropathic or ischaemic pain. From approximately 6000 citations identified, 11 randomised controlled trials (RCTs) were included in the clinical effectiveness review: three of neuropathic pain and eight of ischaemic pain. Trials were available for the neuropathic conditions failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS) type I, and they suggested that SCS was more effective than conventional medical management (CMM) or reoperation in reducing pain. The ischaemic pain trials had small sample sizes, meaning that most may not have been adequately powered to detect clinically meaningful differences. Trial evidence failed to demonstrate that pain relief in critical limb ischaemia (CLI) was better for SCS than for CMM; however, it suggested that SCS was effective in delaying refractory angina pain onset during exercise at short-term follow-up, although not more so than coronary artery bypass grafting (CABG) for those patients eligible for that surgery. The results for the neuropathic pain model suggested that the cost-effectiveness estimates for SCS in patients with FBSS who had inadequate

  5. A process evaluation of systematic risk and needs assessment for caregivers in specialised palliative care

    DEFF Research Database (Denmark)

    Thomsen, Kia Toft; Guldin, Mai-Britt; Nielsen, Mette Kjærgaard

    2017-01-01

    the feasibility of an intervention based on key elements of the "Bereavement support standards for specialist palliative care services" in a Danish specialised palliative home care team. We followed the UK Medical Research Council's guidelines for the process evaluation of complex interventions. The intervention...... was established according to the intervention blueprint for 62% of caregivers receiving targeted support. After managing initial challenges, palliative care staff reported that the intervention was useful and acceptable. CONCLUSION: The intervention proved feasible and useful. Still, we identified barriers...

  6. Model-Based Economic Evaluation of Treatments for Depression: A Systematic Literature Review

    DEFF Research Database (Denmark)

    Kolovos, Spyros; Bosmans, Judith E.; Riper, Heleen

    2017-01-01

    eligible if they used a health economic model with quality-adjusted life-years or disability-adjusted life-years as an outcome measure. Data related to various methodological characteristics were extracted from the included studies. The available modelling techniques were evaluated based on 11 predefined......, and DES models in seven.ConclusionThere were substantial methodological differences between the studies. Since the individual history of each patient is important for the prognosis of depression, DES and ISM simulation methods may be more appropriate than the others for a pragmatic representation...

  7. First systematic evaluation of the potency of Cannabis sativa plants grown in Albania.

    Science.gov (United States)

    Bruci, Zana; Papoutsis, Ioannis; Athanaselis, Sotirios; Nikolaou, Panagiota; Pazari, Ermira; Spiliopoulou, Chara; Vyshka, Gentian

    2012-10-10

    Cannabis products (marijuana, hashish, cannabis oil) are the most frequently abused illegal substances worldwide. Delta-9-tetrahydrocannabinol (THC) is the main psychoactive component of Cannabis sativa plant, whereas cannabidiol (CBD) and cannabinol (CBN) are other major but no ps